• Logo
  • SBMUJournals

Is screening of Staghorn Stones cost-effective?

Ali Muhammad Kavosh, Ali Reza Aminsharifi, Vahid Keshtkar, Abdosaleh Jafari, Gholamreza Abdollahifard
305

Views


Abstract

Background: Staghorn stones can cause damage to the kidneys and are considered as the one of the main cause of renal failure. If they are identified during the initial stages of diagnosis, kidney damage can be prevented. Screening can lead to a better diagnosis. Before the screening, it is necessary to calculate the cost-effectiveness of screening.

Methods: Using the possibility calculations of staghorn stones in the society and different age groups as well as a decision tree model, the screening costs and effectiveness were calculated against no screening. Effectiveness was determined based on the number of prevented cases of renal failure. Ultimately, the incremental cost-effectiveness ration (ICER) was calculated and compared with the World Health Organization (WHO) method based on the gross domestic product (GDP) per capita and subgroup analysis was done for different age groups. In addition, the robustness of results was examined by sensitivity analysis.

Results: The results of decision tree showed that in the screening group, the expected cost was 8815997 USD and the expected effectiveness was 358 and in the no-screening group, the expected cost was 3954214 USD and the expected effectiveness was 258. Based on the results of the study, screening compared with no screening would increase the cost by 4861783                  USD and effectiveness would increase by 100 people. The incremental cost-effectiveness ratio (ICER) showed that for each unit of increase in effectiveness of screening compared with no screening, would lead to an increase the cost by 48618 USD. The results also indicated that screening 30-70-year-old people compared with other age groups (20-70 and 25-70) if done every two years, could reduce the mean costs per preventing each case of renal failure.     

Conclusion: If screening staghorn stones are done every two years for 30-70-year-old individuals, it would be cost effective considering WHO method and 3026 USD could be saved in the health care system per each person. 


References

Amend W, Anderson K, Barbour S, Baskin L, Berger T, Carroll P, et al. Smith’s General Urology. 17th ed. McGraw Hill: LANGE Medical; 2007.

Lotan Y. Economics and Cost of Care of Stone Disease. Advances in Chronic Kidney Disease. 2009; 16(1):5-10.

BasiriA,ShakhssalimN,KhoshdelAR, GhahestaniSM, Basiri H. The demographic profile of urolithiasis in Iran: a nationwide epidemiologic study. IntUrolNephrol. 2010: 42:119–126

KeddisMT,Rule AD. Nephrolithiasis and loss of kidney function. CurrOpinNephrolHypertens. 2013; 22(4): 390–396.

Chung SD, Liu SP, Lin HC. A population-based study on the association between urinary calculi and kidney cancer.CanUrolAssoc J. 2013;7(11-12):E716-21.

Chung SD, Liu SP, Lin HC. Association between prostate cancer and urinary calculi: a population-based study. PLoS One. 2013;8(2):e57743.

Chung SD, Tsai MC, Lin CC, Lin HC.A case-control study on the association between bladder cancer and prior bladder calculus.BMC Cancer. 2013;13:117.

Abdelhafez MF, Amend B, Bedke J, Kruck S, Nagele U, Stenzl A, et al. Minimally Invasive Percutaneous Nephrolithotomy: A Comparative Study of the Management of Small and Large Renal Stones. Urology. 2013; 81: 241-245.

Falahatkar S, Panahandeh Z, Surati A, Akbarpour M, Comparison of the complication of PNL with open surgery in patients with renal staghoran stones. Journal of Guilan University of Medical Sciences. 2008; 68: 63-68.

Desai M, De Lisa A, Turna B, Rioja J, Walfridsson H, D'Addessi A, et al. The clinical research office of the endourological society percutaneous nephrolithotomy global study: staghorn versus nonstaghorn stones. J Endourol. 2011; 25(8):1263-8.

Safarinejad MR. Adult urolithiasis in a population-based study in Iran: prevalence, incidence, and associated risk factors. Urol Res. 2007;35(2):73-82.

Gambaro G, Favaro S, D'Angelo A. Risk for renal failure in nephrolithiasis. Am J Kidney Dis. 2001;37(2):233-43.

Jungers P, Joly D, Barbey F, Choukroun G, Daudon M. ESRD caused by nephrolithiasis: prevalence, mechanisms, and prevention. Am J Kidney Dis. 2004; 44(5):799-805.

Ray AA, Ghiculete D, Pace KT, Honey RJ. Limitations to ultrasound in the detection and measurement of urinary tract calculi. Urology. 2010;76(2):295-300. doi: 10.1016/j.urology.2009.12.015.

Khani M, Hosseini H. Expenses of health facilities in rural and urban health care centers in Zanjan. Research in Medicine. 2003; 27 (2) :129-137

Keshtkaran A , Karimi R , Barouni M , Kavoosi Z , Jafari A. Cost- effectiveness Analysis of Type 2 Diabetes Screening: A case study in Shiraz, Iran. Journal of Health & Development. 2013;2(3): 224-234.

Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes: Oxford university press; 2015.

XinS,Faunce T. Decision-analytical modelling in health-care economic evaluations Eur J Health Econ. 2008;9(4):313-23.

Hutubessy R, Chisholm D, Edejer TT. Generalized cost-effective-ness analysis for national-level priority-setting in the health sector. Cost Eff Resour Alloc.2003;1(1):8.

Taylor M. What is sensitivity analysis? Heslington: University of York; 2009

www.WorldBank.org

www.CBI.ir

Hyams ES, Matlaga BR. Economic impact of urinary stones. TranslAndrol Urol. 2014; 3(3): 278–283.

Strohmaier WL. Economics of stone disease/treatment. Arab J Urol. 2012; 10(3):273-8. doi: 10.1016/j.aju.2012.02.002.

Saigal CS, Joyce G, Timilsina AR; Urologic Diseases in America Project. Direct and indirect costs of nephrolithiasis in an employed population: opportunity for disease management? Kidney Int. 2005; 68(4):1808-14.

Matlaga BR, Jansen JP, Meckley LM, Byrne TW, Lingeman JE. Economic outcomes of treatment for ureteral and renal stones: a systematic literature review. J Urol. 2012; 188(2):449-54. doi: 10.1016/j.juro.2012.04.008.

Siu J, Chen H, Liao P, Chiang J, Chang C, Chen Y, et al. The Cost-Effectiveness of Treatment Modalities for Ureteral Stones: A National Comprehensive Studyl. The Journal of Health Care Organization, Provision, and Financing. 2016;

Chandhoke PS. Economics of urolithiasis: cost-effectiveness of therapies. CurrOpin Urol. 2001; 11(4):391-3.

Sarasin FP, Giostra E, Hadengue A. Cost-effectiveness of screening for detection of small hepatocellular carcinoma in western patients with Child-Pugh class A cirrhosis. Am J Med. 1996; 101(4):422-34.

Goldie SJ, Gaffikin L, Goldhaber-Fiebert JD, Gordillo-Tobar A, Levin C, Mahe C, et al. Cost-Effectiveness of Cervical-Cancer Screening in Five Developing Countries. New Eng J Med. 2005; 353:2158-2168

Frazier AL, Colditz GA, Fuchs CS, Kuntz KM. Cost-effectiveness of screening for colorectal cancer in the general population. JAMA. 2000; 284(15):1954-61.

Sonnenberg A, Delcò F, Inadomi JM. Cost-effectiveness of colonoscopy in screening for colorectal cancer. Ann Intern Med. 2000; 133(8):573-84.




DOI: http://dx.doi.org/10.22037/uj.v0i0.4425

Refbacks

  • There are currently no refbacks.