PMU31 early cost-effectiveness analysis of continuous monitoring of lung-aeration with electrical impedance tomography in preterm neonates with respiratory distress syndrome

Voermans, A., Mewes, J., van Kaam, Anton, Bayford, Richard ORCID logoORCID: and Lepage-Nefkens, I. (2019) PMU31 early cost-effectiveness analysis of continuous monitoring of lung-aeration with electrical impedance tomography in preterm neonates with respiratory distress syndrome. Value in Health, Volume 22, Supplement 3, Pages A1-A2, S403-S940. In: ISPOR Europe 2019, 01 Nov 2019, Copenhagen, Denmark. . ISSN 1098-3015 [Conference or Workshop Item] (doi:10.1016/j.jval.2019.09.1650)

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Respiratory distress syndrome (RDS) is relatively common in preterm neonates due to lung immaturity. Clinical management by respiratory support is associated with high complications rates. Guidance on appropriate lung-aeration is limited using conventional thorax X-ray monitoring. Electrical impedance tomography (EIT) allows radiation-free, continuous lung-aeration monitoring to guide effective respiratory support. EIT produces dynamic images of air volume changes whereas X-ray shows 2-D structure. Clinicians expect EIT implementation to reduce the number of patients requiring mechanical ventilation, overall complication rates and hospitalisation length. We conducted an early cost-effectiveness analysis of EIT-monitoring in preterm neonates with RDS versus standard care in the Netherlands.

A decision-analytic model was constructed comparing costs and effects of conventional X-ray versus EIT-monitoring for preterm neonates with RDS from the healthcare perspective with a time horizon of two years. Input parameters were based on literature and cost databases. The effects of EIT-monitoring were based on consensus by 6 clinical experts for two scenarios, (1) a conservative scenario assuming only a decrease of patients on mechanical ventilation under EIT-monitoring, and (2) an optimistic scenario including scenario (1) and assuming an additional 10% relative complication rate decrease in comparison to standard care. Main outcomes were total average costs per patient, number of patients with bronchopulmonary dysplasia (BPD), and mortality. One-way sensitivity analyses were conducted.

EIT-monitoring was estimated to be cost-saving in both scenarios, mainly due to a shorter average hospital length of stay. Total incremental costs per patient for EIT-monitored care versus standard care were -€929 and -€10,706 for scenario (1) and (2), respectively. The number of patients with BPD and deaths were reduced. Results were robust to changes in input parameters.

EIT lung-aeration monitoring in preterm neonates is expected to result in cost-savings and lower mortality and BPD rates, in comparison to standard care, in a Dutch hospital setting.

Copyright © 2019 Published by Elsevier Inc.

Item Type: Conference or Workshop Item (Paper)
Research Areas: A. > School of Science and Technology > Natural Sciences > Biophysics and Bioengineering group
Item ID: 28959
Notes on copyright: Copyright © 2019 Published by Elsevier Inc. This author's accepted (abstract) manuscript version is made available under the CC-BY-NC-ND 4.0 license
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Depositing User: Richard Bayford
Date Deposited: 04 Feb 2020 09:28
Last Modified: 29 Nov 2022 18:43

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