PMID- 17702906
OWN - NLM
STAT- MEDLINE
DCOM- 20071206
LR  - 20161124
IS  - 0091-4916 (Print)
IS  - 0091-4916 (Linking)
VI  - 35
IP  - 3
DP  - 2007 Sep
TI  - Cost-effectiveness analysis of subtraction scintigraphy in patients with acute 
      lower gastrointestinal tract hemorrhage.
PG  - 140-7
AB  - (99m)Tc-labeled red blood cell scintigraphy is a powerful detection and 
      localization tool that may be confounded by false-positive and false-negative 
      findings. Subtraction scintigraphy has been used in the evaluation of acute lower 
      gastrointestinal tract hemorrhage (LGIH) to reduce the impact of interpretive 
      confounders. The aim of this investigation was to evaluate the cost-effectiveness 
      of the addition of subtraction scintigraphy in the evaluation of patients with 
      acute LGIH. METHODS: The clinical phase of this research was a retrospective 
      clinical study with a repeated-measures design including randomized control and 
      experimental groups. A total of 49 patient studies were included in the sample. 
      Studies were randomized and interpreted by 4 independent physicians. 
      Decision-tree analysis was used to model direct costs and the potential risks of 
      procedures for 2 diagnostic strategies for patients with acute LGIH: conventional 
      scintigraphy alone and conventional scintigraphy combined with subtraction 
      scintigraphy. The transition probabilities (or branching fraction at each 
      decision node) for scintigraphy were based on the clinical results of this 
      investigation. All other transition probabilities were derived from previously 
      cited data. RESULTS: Combining subtraction techniques with conventional 
      scintigraphy reduced the overall costs of procedures for patients with acute LGIH 
      by $74 per patient and reduced deaths by 17.6% and complications by 15.7%. For 
      conventional scintigraphy alone, 8.8% of patients presenting for scintigraphic 
      evaluation of acute LGIH would undergo unnecessary angiograms, and 2.8% would 
      have unnecessary surgery. These figures were reduced to just 5.4% and 1.8%, 
      respectively, with the addition of subtraction scintigraphy. CONCLUSION: The use 
      of subtraction scintigraphy as an adjunct to conventional scintigraphy for 
      patients with acute LGIH may provide both cost and outcome benefits.
FAU - Currie, Geoffrey M
AU  - Currie GM
AD  - School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, New South 
      Wales 2678, Australia. gcurrie@csu.edu.au
LA  - eng
PT  - Journal Article
DEP - 20070816
PL  - United States
TA  - J Nucl Med Technol
JT  - Journal of nuclear medicine technology
JID - 0430303
SB  - IM
MH  - Acute Disease
MH  - Australia/epidemiology
MH  - Cost-Benefit Analysis
MH  - Female
MH  - Gastrointestinal Hemorrhage/*diagnostic imaging/*economics/epidemiology
MH  - Health Care Costs
MH  - Humans
MH  - Lower Gastrointestinal Tract/*diagnostic imaging
MH  - Male
MH  - Radionuclide Imaging/*economics/*statistics & numerical data
MH  - Subtraction Technique/*economics/*statistics & numerical data
EDAT- 2007/08/19 09:00
MHDA- 2007/12/07 09:00
CRDT- 2007/08/19 09:00
PHST- 2007/08/19 09:00 [pubmed]
PHST- 2007/12/07 09:00 [medline]
PHST- 2007/08/19 09:00 [entrez]
AID - jnmt.106.037655 [pii]
AID - 10.2967/jnmt.106.037655 [doi]
PST - ppublish
SO  - J Nucl Med Technol. 2007 Sep;35(3):140-7. doi: 10.2967/jnmt.106.037655. Epub 2007 
      Aug 16.