2022
Cost-effectiveness of endovascular thrombectomy in acute stroke patients with large ischemic core
Sanmartin M, Katz J, Wang J, Malhotra A, Sangha K, Bastani M, Martinez G, Sanelli P. Cost-effectiveness of endovascular thrombectomy in acute stroke patients with large ischemic core. Journal Of NeuroInterventional Surgery 2022, 15: e166-e171. PMID: 36175016, DOI: 10.1136/jnis-2022-019460.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIncremental cost-effectiveness ratioNet monetary benefitProbabilistic sensitivity analysesEconomic evaluation studiesCost-effectiveness analysisCost-effectiveness ratioSensitivity analysisTwo-way sensitivity analysesLifetime healthcare costsMonetary benefitsLife yearsLifetime costsLifetime benefitsLarge ischemic coreStandard careCost-effective strategyEVTIschemic coreStroke patientsAIS patientsPatient's lifetimeAcute ischemic stroke patientsCostEndovascular thrombectomy treatment
2020
CT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis.
Wu X, Hughes DR, Gandhi D, Matouk CC, Sheth K, Schindler J, Wira C, Wintermark M, Sanelli P, Malhotra A. CT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis. Radiology 2020, 294: 580-588. PMID: 31934828, DOI: 10.1148/radiol.2019191238.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionAcute minor strokeBest medical managementMinor strokeCT angiographyMedical managementProbabilistic sensitivity analysesLower health benefitsImmediate thrombectomyHealth benefitsHealth outcomesVascular imagingAcute ischemic strokeMarkov decision-analytic modelWorse health outcomesImproved health outcomesDecision analytic modelNet monetary benefitIntravenous thrombolysisIschemic strokeYounger patientsThrombectomy strategyPatientsAngiographyStroke
2019
Cost-Effectiveness of Computed Tomography Angiography in Management of Tiny Unruptured Intracranial Aneurysms in the United States
Wu X, Matouk CC, Mangla R, Forman HP, Gandhi D, Sanelli P, Malhotra A. Cost-Effectiveness of Computed Tomography Angiography in Management of Tiny Unruptured Intracranial Aneurysms in the United States. Stroke 2019, 50: 2396-2403. PMID: 31340732, DOI: 10.1161/strokeaha.119.025600.Peer-Reviewed Original ResearchConceptsComputed tomography angiographyUnruptured intracranial aneurysmsIntracranial aneurysmsTomography angiographyCancer riskCTA surveillanceCost-effective strategyRadiation-induced brain tumorsRadiation-induced cancer riskSubsequent magnetic resonanceBrain cancer riskBetter health outcomesAnnual rupture riskProbabilistic sensitivity analysesRupture riskLower healthcare spendingAggressive managementPatients 30Subarachnoid hemorrhageIncidental detectionPrior historyHigh riskBrain tumorsAneurysmsHealth outcomesPipeline Endovascular Device vs Stent-Assisted Coiling in Small Unruptured Aneurysms: A Cost-Effectiveness Analysis.
Malhotra A, Wu X, Brinjikji W, Miller T, Matouk CC, Sanelli P, Gandhi D. Pipeline Endovascular Device vs Stent-Assisted Coiling in Small Unruptured Aneurysms: A Cost-Effectiveness Analysis. Neurosurgery 2019, 85: e1010-e1019. PMID: 31329957, DOI: 10.1093/neuros/nyz130.Peer-Reviewed Original ResearchConceptsStent-assisted coilingProbabilistic sensitivity analysesRetreatment rateUnruptured aneurysmsUnruptured anterior circulation aneurysmsPipeline endovascular deviceAnterior circulation aneurysmsLong-term outcomesAneurysm recurrence rateOne-way sensitivity analysesPipeline Embolization DeviceSmall unruptured anterior circulation aneurysmsSmall unruptured aneurysmsSensitivity analysisBetter health outcomesDecision-analytical studyCost-effective relativeCost-effectiveness analysisRecurrence rateStent coilingBase case calculationAneurysm sizeEmbolization DeviceAneurysm recurrenceHealth outcomesComparative effectiveness analysis of Pipeline device versus coiling in unruptured aneurysms smaller than 10 mm.
Malhotra A, Wu X, Miller T, Matouk CC, Sanelli P, Gandhi D. Comparative effectiveness analysis of Pipeline device versus coiling in unruptured aneurysms smaller than 10 mm. Journal Of Neurosurgery 2019, 132: 42-50. PMID: 30641830, DOI: 10.3171/2018.8.jns181080.Peer-Reviewed Original ResearchConceptsPipeline Embolization DeviceStent-assisted coilingRetreatment rateSmall unruptured aneurysmsComparative effectiveness analysisProbabilistic sensitivity analysesUnruptured aneurysmsEndovascular coilingHealth benefitsUse of PEDHigher health benefitsRate of recurrenceFavorable treatment strategyDecision-analytical studyStent-assisted techniquePED placementTreatment modalitiesEffectiveness analysisTreatment strategiesSmall aneurysmsEmbolization DeviceSimple coilingOutcome riskAneurysmsRetreatment
2018
Cost-effectiveness of Magnetic Resonance Imaging in Cervical Clearance of Obtunded Blunt Trauma After a Normal Computed Tomographic Finding
Wu X, Malhotra A, Geng B, Kalra VB, Abbed K, Forman HP, Sanelli P. Cost-effectiveness of Magnetic Resonance Imaging in Cervical Clearance of Obtunded Blunt Trauma After a Normal Computed Tomographic Finding. JAMA Surgery 2018, 153: 625-632. PMID: 29541757, PMCID: PMC5875318, DOI: 10.1001/jamasurg.2018.0099.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingBlunt traumaResonance imagingCervical clearanceNeurologic deficitsTomographic findingsHealth benefitsNational Spinal Cord Injury DatabaseSpinal Cord Injury DatabaseCost of MRISpecificity of MRIUse of MRIPermanent neurologic deficitsGroup of patientsComputed tomographic findingsNegative predictive valueProbabilistic sensitivity analysesCost-effectiveness analysisLower health benefitsCervical CTCT findingsInitial CTNormal CTCervical collarCervical spineCost-Effectiveness Analysis of Intracapsular Tonsillectomy and Total Tonsillectomy for Pediatric Obstructive Sleep Apnea
Bagwell K, Wu X, Baum ED, Malhotra A. Cost-Effectiveness Analysis of Intracapsular Tonsillectomy and Total Tonsillectomy for Pediatric Obstructive Sleep Apnea. Applied Health Economics And Health Policy 2018, 16: 527-535. PMID: 29797301, DOI: 10.1007/s40258-018-0396-4.Peer-Reviewed Original ResearchConceptsProbabilistic sensitivity analysesIncremental cost-effectiveness ratioDeterministic sensitivity analysesMedicaid Services perspectiveResultsBase-case analysisCost-effectiveness analysisCost-effectiveness ratioSensitivity analysisBase-case analysisRelative cost effectivenessEconomic evaluationMedicare ValueDecision modelOSA recurrenceRevision tonsillectomyPartial intracapsular tonsillectomyDecision tree modelCost-effective strategyQALYCase analysisService perspectiveCostCost effectivenessConclusionStudy resultsDisutility
2017
Cost-effectiveness of Magnetic Resonance Imaging in Cervical Spine Clearance of Neurologically Intact Patients With Blunt Trauma
Wu X, Malhotra A, Geng B, Liu R, Abbed K, Forman HP, Sanelli P. Cost-effectiveness of Magnetic Resonance Imaging in Cervical Spine Clearance of Neurologically Intact Patients With Blunt Trauma. Annals Of Emergency Medicine 2017, 71: 64-73. PMID: 28826754, DOI: 10.1016/j.annemergmed.2017.07.006.Peer-Reviewed Original ResearchMeSH KeywordsAdultAftercareCervical VertebraeCost-Benefit AnalysisDecision Support TechniquesHealth Care CostsHumansMagnetic Resonance ImagingMarkov ChainsModels, EconomicQuality-Adjusted Life YearsSensitivity and SpecificitySpinal InjuriesTomography, X-Ray ComputedUnited StatesWounds, NonpenetratingConceptsMagnetic resonance imagingCervical computed tomographyBlunt traumaIntact patientsUnstable injuriesCT resultsResonance imagingCost of MRICervical spine clearanceIncidence of patientsPermanent neurologic deficitsHealth benefitsNegative predictive valueProbabilistic sensitivity analysesInitial CT resultsCervical clearanceSpine clearanceNeurologic deficitsHard collarCord injuryPatient populationAlert patientsComputed tomographyPredictive valuePatients