five

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NIAID Data Ecosystem2026-05-02 收录
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Guidelines recommend using a peripherally inserted central catheter for treatments ≥14 days; however, short peripheral catheters are often used instead. There is a lack of cost-effectiveness studies on their use and associated complications. Our aim was to conduct an economic analysis for this purpose. An economic evaluation study was conducted following local guidelines. A literature search was performed to assess the frequencies of catheter complications, resulting in 1053 papers, narrowing down the selection to 18 articles after independent peer review. Subsequently, experts on each complication were consulted, and a list of necessary items for catheter use was compiled to determine costs. A decision tree strategy model was designed using the TreeAge Pro2015 software tool. For each VAD, branches were constructed including probability nodes with the frequencies of major and minor complications, as well as the costs obtained. The results were measured using the incremental cost-effectiveness ratio. A univariate sensitivity analysis was performed using a tornado diagram, and a multivariate sensitivity analysis was conducted using Monte Carlo simulation. Higher costs were associated with catheter material and insertion by a radiologist. PICC appeared to be more effective for preventing minor complications. Total costs showed a tendency to decrease with nurse-led insertions and lower costs of catheter material in the two-way sensitivity analysis. Data suggests that PICCs are more effective in managing minor complications but come with higher costs. Increasing the utilization of these catheters for extended treatments could lead to reduced overall costs, and a decrease in the incremental cost-effectiveness ratio can be anticipated.
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2024-07-04
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