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Stereoelectroencephalography for Refractory Epileptic Patients Considered for Surgery: Systematic Review, Meta-Analysis, and Economic Evaluation

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorGARCIA-LORENZO, Borja
dc.contributor.authorDEL PINO-SEDENO, T.
dc.contributor.authorROCAMORA, R.
dc.contributor.authorLOPEZ, J. E.
dc.contributor.authorSERRANO-AGUILAR, P.
dc.contributor.authorTRUJILLO-MARTIN, M. M.
dc.date.accessioned2020-06-08T12:08:08Z
dc.date.available2020-06-08T12:08:08Z
dc.date.issued2019-02-01
dc.identifier.issn1524-4040 (Electronic) 0148-396X (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/7815
dc.description.abstractEnBACKGROUND: Stereoelectroencephalography (SEEG) has been shown to be a valuable tool for the anatomoelectroclinical definition of the epileptogenic zone (EZ) in patients with medically refractory epilepsy considered for surgery (RES patients). In Spain, many of those patients are not offered this diagnostic procedure. OBJECTIVE: To evaluate the effectiveness, safety, and cost-effectiveness of SEEG to define the EZ in RES patients compared to no SEEG intervention, ie, remaining with further antiepileptic drugs. METHODS: We undertook a systematic review with meta-analyses on the effectiveness and safety of SEEG. A cost-effectiveness analysis was conducted using a Markov model, which simulates the costs and health outcomes of individuals for a lifetime horizon from the perspective of the Spanish National Health Service. The effectiveness measure was quality-adjusted life years (QALYs). We ran extensive sensitivity analyses, including a probabilistic sensitivity analysis. RESULTS: The EZ was found in 92% of patients who underwent SEEG (95% confidence interval [CI]: 0.87-0.96); 72% were eligible for epilepsy surgery (95% CI: 0.66-0.78) and 33% were free of seizures after surgery (95% CI: 0.27-0.42). Of the patients who underwent surgery, 47% were free of seizures after surgery (95% CI: 0.37-0.58). Complications related to implantation and monitoring of SEEG and the subsequent intervention occurred in 1.3% of patients (95% CI: 0.01-0.02). In the base case analysis, SEEG led to higher QALYs and healthcare costs with an estimated incremental cost-effectiveness ratio of 10 368 EUR per QALY (95% CI: dominant-113 911), making the probability of cost-effectiveness between 75% and 88%. Further sensitivity analyses showed that the results of the study were robust. CONCLUSION: SEEG is a cost-effective technology in RES patients when compared to no SEEG intervention.
dc.language.isoENen_US
dc.subject.enEMOS
dc.title.enStereoelectroencephalography for Refractory Epileptic Patients Considered for Surgery: Systematic Review, Meta-Analysis, and Economic Evaluation
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/neuros/nyy261en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed29982799en_US
bordeaux.journalNeurosurgeryen_US
bordeaux.page326-338en_US
bordeaux.volume84en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue2en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamEconomie et management des organisations de santé – EMOSen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03211521
hal.version1
hal.date.transferred2021-04-28T15:41:32Z
hal.exporttrue
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Neurosurgery&rft.date=2019-02-01&rft.volume=84&rft.issue=2&rft.spage=326-338&rft.epage=326-338&rft.eissn=1524-4040%20(Electronic)%200148-396X%20(Linking)&rft.issn=1524-4040%20(Electronic)%200148-396X%20(Linking)&rft.au=GARCIA-LORENZO,%20Borja&DEL%20PINO-SEDENO,%20T.&ROCAMORA,%20R.&LOPEZ,%20J.%20E.&SERRANO-AGUILAR,%20P.&rft.genre=article


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