Electrocardiographic Screening for Prolonged QT Interval to Reduce XXXX in Psychiatric @entity1 : A Cost-Effectiveness Analysis.

@entity1164 @entity1 @entity1166 @entity146 @entity1162
IMPORTANCE: @entity1164 is a leading cause of mortality in @entity146 @entity1 . @entity1162 ( @entity1162 ) is common in this population and predisposes to @entity1166 ( @entity1166 ) and subsequent mortality. OBJECTIVE: To estimate the cost-effectiveness of electrocardiographic screening to detect @entity1162 in @entity146 inpatients. DESIGN, SETTING, AND @entity1 : We built a decision analytic model based on a decision tree to evaluate the cost-effectiveness and utility of @entity1162 screening from a health care perspective. @entity1162 proportion parameters were derived from an in-hospital cross-sectional study. We performed experts' elicitation to estimate the risk of @entity1166 , given extent of @entity1162 . A @entity1166 of 65% after @entity1162 detection was based on positive drug dechallenge rate and through adequate treatment and electrolyte adjustments. The base-case model uncertainty was assessed with one-way and probabilistic sensitivity analyses. Finally, the @entity1166 related mortality and @entity1166 avoidance parameters were varied in a two-way sensitivity analysis to assess their effect on the Incremental Cost-Effectiveness Ratio (ICER). MAIN OUTCOMES AND MEASURES: Costs, Quality Ajusted Life Year (QALY), ICER, and probability of cost effectiveness thresholds (  10 000,  25 000, and  50 000 per QALY). RESULTS: In the base-case scenario, the numbers of @entity1 needed to screen were 1128 and 2817 to avoid one @entity1166 and one death, respectively. The ICER of systematic ECG screening was  8644 (95%CI, 3144-82 498) per QALY. The probability of cost-effectiveness was 96% at a willingness-to-pay of  50 000 for one QALY. In sensitivity analyses, results were sensitive to the case-fatality of @entity1166 episodes and to the @entity1166 following the diagnosis of @entity1162 . CONCLUSION AND RELEVANCE: In @entity146 hospitals, performing systematic ECG screening at admission help reduce the number of @entity1164 in a cost-effective fashion.
