先进成像技术在癫痫术前检查中的成本效益
Cost-Effectiveness of Advanced Imaging Technologies in the Presurgical Workup of Epilepsy.
作者信息
Kwon Churl-Su, Chang Edward F, Jetté Nathalie
机构信息
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of Health Outcomes & Knowledge Translation Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
Epilepsy Curr. 2020 Jan-Feb;20(1):7-11. doi: 10.1177/1535759719894307. Epub 2020 Jan 7.
The cost-effectiveness and benefit of many diagnostic tests used in the presurgical evaluation for persons with epilepsy is for the most part uncertain as is their influence on decision-making. The options we have at our disposal are ever increasing. Advanced imaging modalities aim to improve surgical candidacy by helping us better define the epileptogenic zone and optimize surgical planning. However, judicious use is important. Randomized controlled trials delineating which mode of investigation is superior are lacking. Presurgical tests do have incremental value by increasing surgical candidacy and refining surgical planning. The yield of additional imaging will increase with complex localization. However, every case must be tailored by hypothesis, cost, and accessibility. Future studies using a quantitative cost-benefit framework are needed to determine the cost-effectiveness of advanced diagnostic tests (beyond magnetic resonance imaging) in the presurgical evaluation of those with epilepsy.
对于癫痫患者术前评估中使用的许多诊断测试，其成本效益和益处大多不确定，它们对决策的影响也不确定。我们可利用的选择在不断增加。先进的成像方式旨在通过帮助我们更好地界定致痫区并优化手术规划来提高手术候选资格。然而，明智地使用很重要。缺乏明确哪种检查模式更优的随机对照试验。术前测试确实通过增加手术候选资格和完善手术规划具有增量价值。随着定位复杂性增加，额外成像的产出也会增加。然而，每个病例都必须根据假设、成本和可及性进行调整。需要未来使用定量成本效益框架的研究来确定先进诊断测试（磁共振成像之外）在癫痫患者术前评估中的成本效益。
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