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Comparing extracorporeal shock wave lithotripsy and ureteroscopy laser lithotripsy for treatment of urinary stones smaller than 2 cm: a cost‑utility analysis in the Spanish clinical setting

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Comparing extracorporeal shock wave lithotripsy and ureteroscopy laser lithotripsy for treatment of urinary stones smaller than 2 cm: a cost‑utility analysis in the Spanish clinical setting

dc.contributor.author	Romeu, Gema
dc.contributor.author	Marzullo‑Zucchet, Leopoldo José
dc.contributor.author	Díaz, Javier
dc.contributor.author	Villarroya, Sara
dc.contributor.author	Budía, Alberto
dc.contributor.author	Guzmán Ordaz, Domingo de
dc.contributor.author	Caballer Tarazona, Vicente
dc.contributor.author	Vivas, David
dc.date.accessioned	2022-01-24T07:38:45Z
dc.date.available	2022-01-24T07:38:45Z
dc.date.issued	2021
dc.identifier.citation	Romeu, Gema Marzullo&#8209Zucchet, Leopoldo José Díaz, Javier Villarroya, Sara Budía, Alberto Guzmán Ordaz, Domingo de Caballer Tarazona, Vicente Vivas, David 2021 Comparing extracorporeal shock wave lithotripsy and ureteroscopy laser lithotripsy for treatment of urinary stones smaller than 2 cm: a cost‑utility analysis in the Spanish clinical setting World Journal of Urology
dc.identifier.uri	https://hdl.handle.net/10550/81402
dc.description.abstract	Purpose To analyze the efciency and cost-utility profle of ureteroscopy versus shock wave lithotripsy for treatment of reno-ureteral stones smaller than 2 cm. Methods Patients treated for urinary stones smaller than 2 cm were included in this study (n=750) and divided into two groups based on technique of treatment. To assess the cost-utility profle a sample of 48 patients (50% of each group) was evaluated. Quality of life survey (Euroqol 5QD-3L) before-after treatment was applied, Markov model was designed to calculate quality of life in each status of the patients (stone or stone-free with and without double-J stent) and to estimate the incremental cost-utility. Monte carlo simulation was conducted for a probabilistic sensitivity analysis. Chi-square was used for comparing qualitative variables and T student's for continuous variables. Results Shock wave lithotripsy group had 408 (54.4%) and ureteroscopy group had 342 (45.6%) patients. Of them, 56.3% were treated for renal stones and 43.7% for ureteral stones. Ureteroscopy produced slightly higher overall quality of patients' life, but produced a signifcant higher overall cost per quality-adjusted life year (QALY) than shock wave lithotripsy, exceeding the cost-utility threshold (20,000 /QALY). Sensitivity analysis confrmed results in 93.65% of cases. Diference was maintained in subgroup analysis (ureteral vs renal stones). Conclusions Results suggest that in our clinical setting shock wave lithotripsy has better cost-utility profle than ureteroscopy for treatment of reno-ureteral stones less than 2 cm, but excluding waiting times, in ideal clinical setting, ureteroscopy would have better cost-utility profle than shock wave lithotripsy.
dc.language.iso	eng
dc.relation.ispartof	World Journal of Urology, 2021
dc.subject	Urologia
dc.title	Comparing extracorporeal shock wave lithotripsy and ureteroscopy laser lithotripsy for treatment of urinary stones smaller than 2 cm: a cost‑utility analysis in the Spanish clinical setting
dc.type	journal article	es_ES
dc.date.updated	2022-01-24T07:38:45Z
dc.identifier.doi	10.1007/s00345-021-03620-w
dc.identifier.idgrec	149784
dc.rights.accessRights	open access	es_ES