Deep endometriosis transvaginal ultrasound in the workup of patients with signs and symptoms of endometriosis: a cost analysis
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Integrating deep endometriosis transvaginal ultrasound into patient workups may save healthcare costs by potentially avoiding a two-step surgical approach.
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Abstract
OBJECTIVE: Deep endometriosis transvaginal ultrasound (DE TVS) is accurate in the detection of ovarian endometriosis and DE; however, realisation of its full potential and utilisation remains variable. As such, patients may require a two-step surgical approach (diagnostic followed by therapeutic laparoscopy) or experience incomplete surgical treatment. Besides the clinical implications, the economic impact of a two-step approach to diagnosis and treatment on the healthcare system is likely to be significant. We aim to compare the economic costs of two diagnostic models of care for patients with potential endometriosis. DESIGN: Cost analysis using Markov model with 12-month time horizon comparing the economic costs of two diagnostic models. SETTING: The study used a hypothetical population of 1000 women visiting a public tertiary gynaecology clinic. POPULATION: Women with potential endometriosis. Estimates for endometriosis prevalence and severity were drawn from local Australian hospital data. METHODS: The conventional model (M1) includes the basic TVS and diagnostic laparoscopy. The novel model (M2) includes the DE TVS. Probabilistic sensitivity analysis was conducted to capture the uncertainty in the information used to populate the models. MAIN OUTCOME MEASURE: Changes to government, health-service and patient costs with the adoption of the DE TVS compared with standard diagnostic methods. Costs are given in Australian dollars (AU$) and also in pound sterling (£). RESULTS: The total annual cost of the novel model (M2) is AU$12,547,724.03 (£6,826,673.63), cheaper than the conventional model (M1), which cost AU$13,472,161.67 (£7,329,620.15). CONCLUSIONS: For a population of 1000 women, the integration of the DE TVS may save healthcare costs of AU$924,437 (£502,946.17) annually. TWEETABLE ABSTRACT: An endometriosis-focused ultrasound may negate a two-step surgery pathway, including diagnostic surgery, and save healthcare money.
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Cited by (16)
- Artificial Intelligence in the Management of Women with Endometriosis and Adenomyosis: Can Machines Ever Be Worse Than Humans? 2024
- Current Practice Patterns, Challenges, and Need for Education in Performing and Reporting Advanced Pelvic US and MRI to Investigate Endometriosis: A Survey by the Canadian Association of Radiologists Endometriosis Working Group 2023
- The Diagnostic Accuracy of Transvaginal Ultrasound for Detection of Ureteral Involvement in Deep Infiltrating Endometriosis: A Systematic Review and Meta-Analysis 2023
- A systematic review and meta-analysis on transvaginal ultrasonography in the diagnosis of deep invasive endometriosis 2022
- Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research 2022
- GnRH Agonists and Antagonists in Endometriosis and Adenomyosis Therapy 2022
- Lessons from implementing the Australian National Action Plan for Endometriosis 2022
- Extragenital endometriosis with lesions of the small and large intestine, the formation of a pathological cavity draining to the anterior abdominal wall (case report) 2021
- Novel diagnostic strategies for endometriosis 2021
- Closing the communication loop between gynecological surgeons, diagnostic imaging experts and pathologists in endometriosis: building bridges between specialties 2021
- Deep learning to diagnose pouch of Douglas obliteration with ultrasound sliding sign 2021
- Assessing the knowledge of endometriosis diagnostic tools in a large, international lay population: an online survey 2021
- <scp>One‐Size‐Fits‐All</scp> Approach Does Not Work for Gynecology Trainees Learning Endometriosis Ultrasound Skills 2020
- Prevalence of Deep Endometriosis and Rectouterine Pouch Obliteration in the Presence of Normal Ovaries 2020
- A Multicenter International Temporal and External Validation Study of the Ultrasound-based Endometriosis Staging System 2020
- International survey finds majority of gynecologists are not aware of and do not utilize ultrasound techniques to diagnose and map endometriosis 2020
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