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 ResearchMeSH KeywordsCost-Benefit AnalysisCost-Effectiveness AnalysisHumansIschemic StrokeStrokeThrombectomyConceptsQuality-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
Implications of achieving TICI 2b vs TICI 3 reperfusion in patients with ischemic stroke: a cost-effectiveness analysis
Wu X, Khunte M, Gandhi D, Matouk C, Hughes DR, Sanelli P, Malhotra A. Implications of achieving TICI 2b vs TICI 3 reperfusion in patients with ischemic stroke: a cost-effectiveness analysis. Journal Of NeuroInterventional Surgery 2020, 12: 1161-1165. PMID: 32457225, DOI: 10.1136/neurintsurg-2020-015873.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsLarge vessel occlusionTICI 3 reperfusionEndovascular thrombectomyTICI 2bTICI 3Stroke patientsHealth benefitsAge groupsAcute stroke patientsDegree of recanalizationDegree of reperfusionLifetime quality-adjusted life yearsCost-effectiveness analysisDecision analytic studyUnited States settingsIncomplete reperfusionIschemic strokeComplete reperfusionPatient selectionReperfusionPatientsHealth outcomesLife yearsCost savingsCT 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 ResearchMeSH KeywordsAgedAged, 80 and overComputed Tomography AngiographyCost-Benefit AnalysisHumansMiddle AgedStrokeTriageConceptsLarge 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 ResearchMeSH KeywordsAdultComputed Tomography AngiographyCost-Benefit AnalysisDisease ManagementFemaleFollow-Up StudiesHumansIntracranial AneurysmMaleMiddle AgedUnited StatesConceptsComputed 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 outcomesManagement of Unruptured Intracranial Aneurysms in Older Adults: A Cost-effectiveness Analysis.
Malhotra A, Wu X, Forman HP, Matouk CC, Hughes DR, Gandhi D, Sanelli P. Management of Unruptured Intracranial Aneurysms in Older Adults: A Cost-effectiveness Analysis. Radiology 2019, 291: 411-417. PMID: 30888931, DOI: 10.1148/radiol.2019182353.Peer-Reviewed Original ResearchMR Angiography Screening and Surveillance for Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease: A Cost-effectiveness Analysis
Malhotra A, Wu X, Matouk CC, Forman HP, Gandhi D, Sanelli P. MR Angiography Screening and Surveillance for Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease: A Cost-effectiveness Analysis. Radiology 2019, 291: 400-408. PMID: 30777807, DOI: 10.1148/radiol.2019181399.Peer-Reviewed Original ResearchComparative 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 ResearchMeSH KeywordsAdultCervical VertebraeCost-Benefit AnalysisFollow-Up StudiesHumansMagnetic Resonance ImagingSpinal InjuriesTomography, X-Ray ComputedWounds, NonpenetratingConceptsMagnetic 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
2016
Utility of MRI for cervical spine clearance after blunt traumatic injury: a meta-analysis
Malhotra A, Wu X, Kalra VB, Nardini HK, Liu R, Abbed KM, Forman HP. Utility of MRI for cervical spine clearance after blunt traumatic injury: a meta-analysis. European Radiology 2016, 27: 1148-1160. PMID: 27334017, DOI: 10.1007/s00330-016-4426-z.Peer-Reviewed Original ResearchMeSH KeywordsCervical VertebraeCost-Benefit AnalysisDatabases, FactualHumansMagnetic Resonance ImagingSpinal InjuriesTomography, X-Ray ComputedWounds, NonpenetratingConceptsPositive finding rateUnstable injuriesUtility of MRIAlert patientsPooled incidenceCervical spine trauma patientsCervical spine clearanceBlunt traumatic injurySpine trauma patientsMajor medical databasesFurther studiesCS clearanceSpine clearanceTrauma patientsAwake patientsNegative CTTraumatic injuryPatientsUnique citationsSystematic reviewInjuryPositive findingsIncidenceMRIHigh false positive rateCost‐effectiveness Analysis of Follow‐up Strategies for Thunderclap Headache Patients With Negative Noncontrast CT
Malhotra A, Wu X, Kalra VB, Schindler J, Forman HP. Cost‐effectiveness Analysis of Follow‐up Strategies for Thunderclap Headache Patients With Negative Noncontrast CT. Academic Emergency Medicine 2016, 23: 243-250. PMID: 26728524, DOI: 10.1111/acem.12891.Peer-Reviewed Original ResearchCost-effectiveness analysis of CTA and LP for evaluation of suspected SAH after negative non-contrast CT
Wu X, Kalra VB, Forman HP, Malhotra A. Cost-effectiveness analysis of CTA and LP for evaluation of suspected SAH after negative non-contrast CT. Clinical Neurology And Neurosurgery 2016, 142: 104-111. PMID: 26827168, DOI: 10.1016/j.clineuro.2015.12.021.Peer-Reviewed Original Research
2015
Evaluation for Blunt Cerebrovascular Injury: Review of the Literature and a Cost-Effectiveness Analysis
Malhotra A, Wu X, Kalra VB, Schindler J, Matouk CC, Forman HP. Evaluation for Blunt Cerebrovascular Injury: Review of the Literature and a Cost-Effectiveness Analysis. American Journal Of Neuroradiology 2015, 37: 330-335. PMID: 26450540, PMCID: PMC7959958, DOI: 10.3174/ajnr.a4515.Peer-Reviewed Original ResearchConceptsCost-effective imaging strategyNet monetary benefitHealth care payer perspectiveIncremental cost-effectiveness ratioCare payer perspectiveCost-effectiveness analysisCost-effective strategyCost-effectiveness ratioEconomic evaluationMonetary benefitsDominant strategyMain indicatorsPayer perspectiveSelective DSAComparable utilityUtility perspectiveDecision tree analysisSelective anticoagulationSensitivity analysisCostImmense controversyHigh costCTA sensitivityParameter valuesHorizonScreening for Pediatric Blunt Cerebrovascular Injury: Review of Literature and a Cost-Effectiveness Analysis
Malhotra A, Wu X, Kalra VB, Goodman TR, Schindler J, Forman HP. Screening for Pediatric Blunt Cerebrovascular Injury: Review of Literature and a Cost-Effectiveness Analysis. Journal Of Pediatric Surgery 2015, 50: 1751-1757. PMID: 26546389, DOI: 10.1016/j.jpedsurg.2015.05.005.Peer-Reviewed Original ResearchMeSH KeywordsCerebral AngiographyCerebrovascular TraumaChildCost-Benefit AnalysisDecision TreesHead Injuries, ClosedHumansMonte Carlo MethodTomography, X-Ray ComputedConceptsBlunt cerebrovascular injuryPediatric blunt cerebrovascular injurySelective computed tomography angiographyComputed tomography angiographyOptimal imaging strategyCost-effectiveness analysisAnticoagulation therapyCerebrovascular injuryManagement of BCVIAppropriate anticoagulation therapyHigh-risk patientsHigh-risk factorsImaging strategiesPossible screening strategiesReview of literatureSelective anticoagulationPediatric patientsAnticoagulation complicationsTomography angiographySystematic reviewPatientsSocietal perspectiveCost-effective strategyData extractionScreening strategy
2014
Cost-Effectiveness of Angiographic Imaging in Isolated Perimesencephalic Subarachnoid Hemorrhage
Kalra VB, Wu X, Forman HP, Malhotra A. Cost-Effectiveness of Angiographic Imaging in Isolated Perimesencephalic Subarachnoid Hemorrhage. Stroke 2014, 45: 3576-3582. PMID: 25336513, DOI: 10.1161/strokeaha.114.006679.Peer-Reviewed Original ResearchMeSH KeywordsAngiography, Digital SubtractionCerebral AngiographyCost-Benefit AnalysisDecision TreesHumansMonte Carlo MethodSubarachnoid HemorrhageConceptsOptimal strategyNet monetary benefitCost-effectiveness analysisComprehensive cost-effectiveness analysisCost-effective strategyBase case scenarioDistributional variablesMonetary benefitsLife yearsWillingnessBase caseSensitivity analysisMonte Carlo simulationsInitial CTAPayCarlo simulationsPart of followCostStrategiesVariablesBenefitsDecision treeCase scenarioPurpose