Cost-effectiveness of ultrasound-guided liver biopsy

Tousif Pasha, Sherine Gabriel, Terry M Therneau, E. Rolland Dickson, Keith D. Lindor

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

The risk of a major complication from 'blind' percutaneous liver biopsy is reported to be in the range of 0.24% to 3.8%. In a recent randomized trial, patients whose liver biopsies were performed with ultrasonography had a significant reduction in complications requiring hospitalization compared with patients without ultrasound-guided biopsies (0.5% vs. 2.2%, P < .05). Despite this, routine use of ultrasonography for liver biopsies has not been implemented because of controversies with respect to cost-effectiveness. The aim of our study was to analyze the relative cost-effectiveness of performing ultrasound-guided liver biopsies using decision analysis. A decision tree was constructed to compare a strategy of liver biopsy using ultrasonography with a strategy without ultrasonography. The major outcomes included were minor complications such as pain requiring analgesics and major complications, which require hospitalization. Costs included were direct medical costs from the payer's perspective. In our baseline model, the cost from complications per patient with and without ultrasonography was $62 and $129, respectively. The marginal effectiveness expressed as the number of major complications avoided was 1.2/100 liver biopsies. The incremental cost to avoid one major complication was $2,731. The model was most sensitive to the frequency of major complications and the additional cost of ultrasonography. Our decision analysis model suggests that ultrasound-guided liver biopsy is cost- effective. Future studies assessing the efficacy of image-guided liver biopsies should be conducted.

Original languageEnglish (US)
Pages (from-to)1220-1226
Number of pages7
JournalHepatology
Volume27
Issue number5
DOIs
StatePublished - 1998

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Cost-Benefit Analysis
Biopsy
Ultrasonography
Liver
Costs and Cost Analysis
Decision Support Techniques
Hospitalization
Image-Guided Biopsy
Decision Trees
Analgesics
Pain

ASJC Scopus subject areas

  • Hepatology

Cite this

Pasha, T., Gabriel, S., Therneau, T. M., Rolland Dickson, E., & Lindor, K. D. (1998). Cost-effectiveness of ultrasound-guided liver biopsy. Hepatology, 27(5), 1220-1226. https://doi.org/10.1002/hep.510270506

Cost-effectiveness of ultrasound-guided liver biopsy. / Pasha, Tousif; Gabriel, Sherine; Therneau, Terry M; Rolland Dickson, E.; Lindor, Keith D.

In: Hepatology, Vol. 27, No. 5, 1998, p. 1220-1226.

Research output: Contribution to journalArticle

Pasha, T, Gabriel, S, Therneau, TM, Rolland Dickson, E & Lindor, KD 1998, 'Cost-effectiveness of ultrasound-guided liver biopsy', Hepatology, vol. 27, no. 5, pp. 1220-1226. https://doi.org/10.1002/hep.510270506
Pasha T, Gabriel S, Therneau TM, Rolland Dickson E, Lindor KD. Cost-effectiveness of ultrasound-guided liver biopsy. Hepatology. 1998;27(5):1220-1226. https://doi.org/10.1002/hep.510270506
Pasha, Tousif ; Gabriel, Sherine ; Therneau, Terry M ; Rolland Dickson, E. ; Lindor, Keith D. / Cost-effectiveness of ultrasound-guided liver biopsy. In: Hepatology. 1998 ; Vol. 27, No. 5. pp. 1220-1226.
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