Evidence map›Paper›PMID 32443305›Full record

ArticleMedicine2020

The cost-effectiveness of empirical antibiotic treatments for high-risk febrile neutropenic patients: A decision analytic model.

Katerina Tori, Giannoula S Tansarli, Diane M Parente, Markos Kalligeros, Panayiotis D Ziakas, Eleftherios Mylonakis

Open access · goldAbstract read
In one paragraph

Article in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 49% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Katerina ToriDivision of Infectious Diseases, Brown University, Warren Alpert Medical School.
Giannoula S TansarliDivision of Infectious Diseases, Brown University, Warren Alpert Medical School.
Diane M ParenteDepartment of Pharmacy, The Miriam Hospital, Providence, Rhode Island, USA.
Markos KalligerosDivision of Infectious Diseases, Brown University, Warren Alpert Medical School.
Panayiotis D ZiakasDivision of Infectious Diseases, Brown University, Warren Alpert Medical School.
Eleftherios MylonakisDivision of Infectious Diseases, Brown University, Warren Alpert Medical School.
Brown University · USMiriam Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFebrile neutropenia has a significant clinical and economic impact on cancer patients. This study evaluates the cost-effectiveness of different current empiric antibiotic treatments.

methodsA decision analytic model was constructed to compare the use of cefepime, meropenem, imipenem/cilastatin, and piperacillin/tazobactam for treatment of high-risk patients. The analysis was performed from the perspective of U.S.-based hospitals. The time horizon was defined to be a single febrile neutropenia episode. Cost-effectiveness was determined by calculating costs and deaths averted. Cost-effectiveness acceptability curves for various willingness-to-pay thresholds (WTP), were used to address the uncertainty in cost-effectiveness.

resultsThe base-case analysis results showed that treatments were equally effective but differed mainly in their cost. In increasing order: treatment with imipenem/cilastatin cost $52,647, cefepime $57,270, piperacillin/tazobactam $57,277, and meropenem $63,778. In the probabilistic analysis, mean costs were $52,554 (CI: $52,242-$52,866) for imipenem/cilastatin, $57,272 (CI: $56,951-$57,593) for cefepime, $57,294 (CI: $56,978-$57,611) for piperacillin/tazobactam, and $63,690 (CI: $63,370-$64,009) for meropenem. Furthermore, with a WTP set at $0 to $50,000, imipenem/cilastatin was cost-effective in 66.2% to 66.3% of simulations compared to all other high-risk options. DISCUSSION: Imipenem/cilastatin is a cost-effective strategy and results in considerable health care cost-savings at various WTP thresholds. Cost-effectiveness analyses can be used to differentiate the treatments of febrile neutropenia in high-risk patients.

Indexed as

Anti-Bacterial AgentsCefepimeCilastatin, Imipenem Drug CombinationComputer SimulationCost-Benefit AnalysisDecision Support TechniquesFeverHealth Care CostsHumansMeropenemNeutropeniaPiperacillin, Tazobactam Drug CombinationTreatment OutcomeAnti-Bacterial AgentsCefepimeCilastatin, Imipenem Drug CombinationMeropenemPiperacillin, Tazobactam Drug Combination

Identifiers

PMID32443305
PMCPMC7254453
OpenAlexW3026630276

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.