Linked Life Data

3142261

Source:http://linkedlifedata.com/resource/pubmed/id/3142261

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
1988-12-22
pubmed:abstractText
Intraoperative ureteral injuries are potentially serious iatrogenic complications. Routine preoperative intravenous pyelograms might decrease the risk of such injuries during hysterectomy in cases of nonmalignant disease, but no prospective studies have been conducted to determine their effectiveness. Since gynecologists must frequently decide whether to obtain pyelograms, we used decision analysis to determine how costly routine pyelograms would be and under what circumstance pyelograms might be especially justifiable. Our cost-effectiveness study was based on decision analysis techniques, with the best available estimates from the literature, and on expert opinion. These estimates were varied over a broad range during a sensitivity analysis so as not to bias the results. At a baseline ureteral incidence injury rate of 0.5%, the marginal cost-effectiveness ratio indicates 833 pyelograms would be obtained to prevent a single injury and approximately $3.33 million would be spent to prevent a single death. As the probability of an injury increases, the marginal cost-effectiveness ratio is less dependent on the test efficacy and is more modest. Since abnormal ureteral anatomy probably predicts ureteral injury, we suggest selectively obtaining preoperative pyelograms only when the probability of an abnormality is high.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
0002-9378
pubmed:author
pubmed:issnType
Print
pubmed:volume
159
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1049-53
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
1988
pubmed:articleTitle
Routine intravenous pyelograms before hysterectomy in cases of benign disease: possibly effective, definitely expensive.
pubmed:affiliation
Health Services Research Field Program, Duke University, Durham, NC 27710.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't