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Vol. 39. Issue 1.
Pages 40-46 (January - February 2015)
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Vol. 39. Issue 1.
Pages 40-46 (January - February 2015)
Original article
Cost-effectiveness analysis of main diagnosis tools in women with overactive bladder. Clinical history, micturition diary and urodynamic study
Análisis coste-efectividad de las principales herramientas diagnósticas en mujeres con vejiga hiperactiva: historia clínica, diario miccional y estudio urodinámico
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L. López-Fando
Corresponding author
urologia@lopez-fando.com

Corresponding author.
, D. Carracedo, M. Jiménez, J.M. Gómez-Vicente, L. Martínez, C. Gómez-Cañizo, V. Gómez, F.J. Burgos
Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Tables (5)
Table 1. Clinical resource consumption and micturition diary.
Table 2. Consumption of resources of the Urodynamic Study.
Table 3. Performance of the key diagnostic tools in women with HIV.
Table 4. Cost-effectiveness analysis of the diagnostic tools in women with HIV.
Table 5. Incremental ratio with respect to diagnostic tests in the study of women with HIV.
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Abstract
Objectives

The aim of the present clinical research is to analyze, in the light of the best scientific evidence, the performance and the cost of the main diagnostic tools for overactive bladder (OAB).

Methods

It is an exploratory transversal study in which 199 women diagnosed of OAB between 2006 and 2008 were selected and underwent to following prospective analyses: physical examination, urine analysis, micturition diary (MD) and urodynamic study (UDS). A percentage of 80% was assumed as highly sensitive and a diagnostic difference among tests of 10% would be considered clinically relevant. Tests’ sensitivity for diagnosis of OAB was statistically established by two ways: isolated and combined. Besides, the direct and indirect costs of these tests performance were conducted. Cost-effectiveness study of clinical history (CH), MD and US for the diagnosis of OAB was performed.

Results

Overall sensitivity for OAB diagnosis is low for the 3 tests used in isolated way, whilst the combination of any two tests shows good overall sensitivity. The combination of CH and MD has appeared as the most cost-effective alternative to OAB diagnosis.

Conclusions

For OAB diagnosis, CH-DM combination shows the same sensitivity than the association of either of them with the UDS, but unlike to these, it shows the lowest cost.

Keywords:
Cost-effectiveness
Overactive bladder
Micturition diary
Resumen
Objetivos

El presente trabajo de investigación clínica pretende analizar a la luz de la mejor evidencia científica el rendimiento y el coste de las principales herramientas utilizadas en el diagnóstico de la vejiga hiperactiva (VH).

Metodos

Se trata de un estudio transversal exploratorio y analítico, en el cual se seleccionó una muestra de 199 mujeres diagnosticadas de VH entre los años 2006 y 2008, a las que se realizó de forma prospectiva: exploración física, análisis de orina, diario miccional (DM) y estudio urodinámico (EUD). Se asumió que un porcentaje de diagnóstico altamente sensible debería ser 80% y que una diferencia de diagnóstico del 10% entre las pruebas sería clínicamente relevante. Se determinó estadísticamente la sensibilidad de cada una de las pruebas de forma aislada y combinada para el diagnóstico de VH y una valoración de los recursos económicos directos e indirectos que conlleva su realización, analizándose el coste efectividad de la historia clínica (HC), DM y EUD para el diagnóstico de VH.

Resultados

La sensibilidad global para el diagnóstico de VH es baja para cualquiera de las pruebas utilizadas de forma aislada, mientras que la combinación de 2 pruebas cualesquiera presenta una buena sensibilidad global para su diagnóstico. La combinación de HC y DM es la alternativa más coste efectiva en el diagnóstico de VH.

Conclusiones

El uso de HC y DM es una combinación tan sensible para el diagnóstico de la VH como la asociación de cualquiera de ellas con el EUD, presentando además un menor coste económico.

Palabras clave:
Coste-efectividad
Vejiga hiperactiva
Diario miccional

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