Evidence map›Paper›PMID 36609935›Full record

ArticleInternational urology and nephrology2023

Cost-effectiveness of routine type and screens in select urological surgeries.

Joshua Volin, Joshua Daniel, Brianna Walter, Patrick Herndon, Deanna Tran, James Blumline, Aviv Spillinger, Patrick Karabon, Craig Fletcher, Adam Folbe and 1 more

Abstract read
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In one paragraph

Article in International urology and nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

11 authors.

Joshua VolinOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
Joshua DanielOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
Brianna WalterOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA. blwalter2@oakland.edu.ORCID http://orcid.org/0000-0002-8679-1450
Patrick HerndonOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
Deanna TranOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
James BlumlineOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
Aviv SpillingerOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
Patrick KarabonOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
Craig FletcherOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
Adam FolbeOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.
Jason HafronOakland University William Beaumont School of Medicine, Oakland University, Rochester, MI, 48309, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the cost-effectiveness of obtaining a preoperative type and screen (T/S) for common urologic procedures.

methodsA decision tree model was constructed to track surgical patients undergoing two preoperative blood ordering strategies as follows: obtaining a preoperative T/S versus not doing so. The model was applied to the National (Nationwide) Inpatient Sample (NIS) data, from January 1, 2006 to September 30, 2015. Cost estimates for the model were created from combined patient-level data with published costs of a T/S, type and crossmatch (T/C), a unit of pRBC, and one unit of emergency-release transfusion (ERT). The primary outcome was the incremental cost per ERT prevented, expressed as an incremental cost-effectiveness ratio (ICER) between the two preoperative blood ordering strategies. A cost-effectiveness analysis determined the ICER of obtaining preoperative T/S to prevent an emergency-release transfusion (ERT), with a willingness-to-pay threshold of $1,500.00.

resultsA total of 4,113,144 surgical admissions from 2006 to 2015 were reviewed. The overall transfusion rate was 10.54% (95% CI, 10.17-10.91) for all procedures. The ICER of preoperative T/S was $1500.00 per ERT prevented. One-way sensitivity analysis demonstrated that the risk of transfusion should exceed 4.12% to justify preoperative T/S.

conclusionRoutine preoperative T/S for radical prostatectomy (rate = 3.88%) and penile implants (rate = .91%) does not represent a cost-effective practice for these surgeries. It is important for urologists to review their institution T/S policy to reduce inefficiencies within the preoperative setting.

Indexed as

Blood Grouping and CrossmatchingBlood TransfusionCost-Benefit AnalysisCost-Effectiveness AnalysisHumansMaleUrologic Surgical ProceduresBlood grouping and crossmatchingBlood lossBlood transfusionPenile implantsProstatectomySurgicalUrologic surgery

Identifiers

PMID36609935

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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.