162 cohorts of 1000 patients in the duration of one year. Differences in cost - benefit balance are mostly due to the varying costs of imaging modalities set against their sensitivity and specificity in both aneurysm detection and coilability assessment. Our model shows that a diagnostic DSA in all patients is more cost- effective than CTA or MRA as single diagnostic modality before treatment, but that a combination of CTA with DSA, where DSA is performed when CTA detects no aneurysm or finds an aneurysm not suitable for endovascular treatment, is marginally more cost-effective than a diagnostic DSA in all patients. The difference in cost between this combination and a diagnostic DSA in all patients may appear minimal (0.1%: 41 Euro on top of a total one year estimated cost of nearly 40,000 Euro), but we expect this difference to be bigger in practice, as we explain in Chapter 8. Finally in Chapter 9 we make nine proposals for treatment and assessment of SAH, based on the results from our own research in combination with results from the published research described in Chapter 1. These proposals provide a basis for discussion and future research, for which we give a few suggestions at the end of chapter 9.
proefschrit Van Zwam inhoud met kaft en stellingen.indd
To see the actual publication please follow the link above