PT -期刊文章盟尼古拉斯颜凯盟——艾玛·福斯特盟——克拉拉Marquina AU -安迪谭盟萨曼莎s.t。彭日成AU -特伦斯j . O ' brien AU -帕特里克关颖珊盟格雷姆杰克逊AU - Zhibin陈盟Zanfina Ademi TI -系统评估的成本效益分析外科和神经刺激治疗癫痫耐药- 10.1212 / WNL成人援助。0000000000207137 DP - 2023年3月16日TA -神经病半岛投注体育官网学PG - 10.1212 / WNL。0000000000207137 4099 - http://n.半岛投注体育官网neurology.org/content/early/2023/03/15/WNL.0000000000207137.short 4100 - //www.ebmtp.com/content/early/2023/03/15/WNL.0000000000207137.full AB -背景和目标:外科和神经治疗能有效地降低在选定的个人生活与耐药性癫痫发作负担(DRE)。我们旨在确定和关键决定因素模型存在这些干预措施的成本效益,而医疗管理,协助决定资源分配。方法:进行系统的文献检索6月1日,2022年,利用Medline、Embase, NHS经济评价数据库,数据库和成本效益分析。包括经济评价研究成人DRE军团;比较手术和神经治疗(迷走神经刺激(VNS),响应神经刺激(RNS)和脑深部刺激(DBS))和医疗管理;和报告的成本效益分析、成本效用或成本效益。排除标准与儿科人群研究和发表在英语以外的其他语言。三个独立评论员筛选、提取和评估数据与巩固卫生经济评价报告标准(欢呼)检查表,和第四个审稿人裁决差异。结果:10个研究符合纳入标准。七个研究评价癫痫手术,和三个评估神经刺激治疗。所有相关研究证实癫痫手术相比,具有成本效益的干预医疗管理,至于质量调整生命年(提升),和没收的自由在2 - 5年。 All relevant studies found neurostimulator treatments to be potentially cost-effective. The incremental cost-effectiveness ratio (ICER), with lower ICER indicating greater cost-effectiveness, was reported for nine studies, and varied between GBP £3,013 and US $61,333. Cost adaptation revealed ICERs from US $170 to US $121,726. Key model determinants included, but were not limited to, improved surgical outcomes and quality of life, reduced surgical and presurgical evaluation costs, higher rates of surgical eligibility after referral and evaluation, epilepsy subtype, less expensive neurostimulator devices with improved longevity, and cost analysis strategy used in the analysis.Discussion: There is consistent evidence that epilepsy surgery is a cost-effective treatment for eligible candidates with DRE. Limited evidence suggests that VNS, RNS, and DBS may be cost-effective therapies for DRE, although more health economic evaluations alongside prospective clinical trials are needed to validate these findings.

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