G P Conners1. 1. Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, New York, USA.
Abstract
BACKGROUND: The choice among endoscopy, Foley catheter, and bougienage techniques for pediatric esophageal coin removal currently depends on local or personal preferences. This reflects a lack of prospective comparisons of cost and effectiveness in the literature. METHODS: A computerized decision analytic model was used to determine the expected costs of each method of esophageal coin removal. Calculations were based on success rates in the recent literature and local patient charges for each method. Complications reported in this recent literature were also tabulated. MAIN RESULTS: Of 1746 esophageal coin removal attempts reported in 24 papers, 1706 (97.7%) were successful. There were 37 (2.1%) complications, the majority of which were minor. The expected cost of endoscopic coin removal was $2701; of Foley catheter removal, $660; of bougienage removal, $614. The large difference in expected cost of endoscopy and bougienage or Foley catheter removal persisted in sensitivity analyses. CONCLUSIONS: In a literature-based decision analytic model, pediatric esophageal coin removal by the Foley catheter or bougienage technique was far more cost-effective than was endoscopy.
BACKGROUND: The choice among endoscopy, Foley catheter, and bougienage techniques for pediatric esophageal coin removal currently depends on local or personal preferences. This reflects a lack of prospective comparisons of cost and effectiveness in the literature. METHODS: A computerized decision analytic model was used to determine the expected costs of each method of esophageal coin removal. Calculations were based on success rates in the recent literature and local patient charges for each method. Complications reported in this recent literature were also tabulated. MAIN RESULTS: Of 1746 esophageal coin removal attempts reported in 24 papers, 1706 (97.7%) were successful. There were 37 (2.1%) complications, the majority of which were minor. The expected cost of endoscopic coin removal was $2701; of Foley catheter removal, $660; of bougienage removal, $614. The large difference in expected cost of endoscopy and bougienage or Foley catheter removal persisted in sensitivity analyses. CONCLUSIONS: In a literature-based decision analytic model, pediatric esophageal coin removal by the Foley catheter or bougienage technique was far more cost-effective than was endoscopy.
Authors: Gautam Bir Singh; Damyanti Aggarwal; B D Mathur; T K Lahiri; M K Aggarwal; R K Jain Journal: Indian J Otolaryngol Head Neck Surg Date: 2009-03-31