S Sajith Kumar, G Suchitra Lakshmi, Aamir Sohail, Kayala Venkata Jagadeesh, Bhavani Shankara Bagepally
{"title":"阻塞性睡眠呼吸暂停治疗的成本效益：成本效用研究的系统回顾和荟萃分析。","authors":"S Sajith Kumar, G Suchitra Lakshmi, Aamir Sohail, Kayala Venkata Jagadeesh, Bhavani Shankara Bagepally","doi":"10.1080/14737167.2025.2451733","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by recurrent episodes of nocturnal breathing cessation resulting from upper airway collapse. Given the absence of a comprehensive review of the cost-effectiveness of OSA treatments, we undertook an extensive systematic review and meta-analysis to calculate the pooled incremental net benefit (INBp).</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Scopus, and Tufts cost-effectiveness analysis registry was conducted. INBp with 95% confidence intervals (CI) was estimated using a random-effects model, and heterogeneity was assessed through the Cochrane-Q test and I<sup>2</sup> statistic. Study quality was evaluated using the modified ECOBIAS Checklist, and GRADE framework was applied to assess the certainty of outcomes.</p><p><strong>Results: </strong>Thirty-four studies were included in the systematic review, fifteen qualifying for meta-analysis. CPAP was cost-effective compared to other treatments, with a INBp of $13,024 (95%CI $6,813 to $19,236), and substantial heterogeneity (I<sup>2</sup> = 97.48%). Compared to no treatment and oral appliances (OAs), CPAP showed cost-effective INB values of $30,834 ($21,325 to $40,343) and $2,708 ($645 to $4,771) respectively.</p><p><strong>Conclusion: </strong>CPAP is cost effective compared to all treatments collectively, as well as specifically to OAs and no treatment though with low certainty.</p>","PeriodicalId":12244,"journal":{"name":"Expert Review of Pharmacoeconomics & Outcomes Research","volume":" ","pages":"1-9"},"PeriodicalIF":1.8000,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cost effectiveness of obstructive sleep apnea therapies: a systematic review and meta-analysis of cost utility studies.\",\"authors\":\"S Sajith Kumar, G Suchitra Lakshmi, Aamir Sohail, Kayala Venkata Jagadeesh, Bhavani Shankara Bagepally\",\"doi\":\"10.1080/14737167.2025.2451733\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by recurrent episodes of nocturnal breathing cessation resulting from upper airway collapse. Given the absence of a comprehensive review of the cost-effectiveness of OSA treatments, we undertook an extensive systematic review and meta-analysis to calculate the pooled incremental net benefit (INBp).</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Scopus, and Tufts cost-effectiveness analysis registry was conducted. INBp with 95% confidence intervals (CI) was estimated using a random-effects model, and heterogeneity was assessed through the Cochrane-Q test and I<sup>2</sup> statistic. Study quality was evaluated using the modified ECOBIAS Checklist, and GRADE framework was applied to assess the certainty of outcomes.</p><p><strong>Results: </strong>Thirty-four studies were included in the systematic review, fifteen qualifying for meta-analysis. CPAP was cost-effective compared to other treatments, with a INBp of $13,024 (95%CI $6,813 to $19,236), and substantial heterogeneity (I<sup>2</sup> = 97.48%). 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Cost effectiveness of obstructive sleep apnea therapies: a systematic review and meta-analysis of cost utility studies.
Objectives: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by recurrent episodes of nocturnal breathing cessation resulting from upper airway collapse. Given the absence of a comprehensive review of the cost-effectiveness of OSA treatments, we undertook an extensive systematic review and meta-analysis to calculate the pooled incremental net benefit (INBp).
Methods: A systematic search of PubMed, Embase, Scopus, and Tufts cost-effectiveness analysis registry was conducted. INBp with 95% confidence intervals (CI) was estimated using a random-effects model, and heterogeneity was assessed through the Cochrane-Q test and I2 statistic. Study quality was evaluated using the modified ECOBIAS Checklist, and GRADE framework was applied to assess the certainty of outcomes.
Results: Thirty-four studies were included in the systematic review, fifteen qualifying for meta-analysis. CPAP was cost-effective compared to other treatments, with a INBp of $13,024 (95%CI $6,813 to $19,236), and substantial heterogeneity (I2 = 97.48%). Compared to no treatment and oral appliances (OAs), CPAP showed cost-effective INB values of $30,834 ($21,325 to $40,343) and $2,708 ($645 to $4,771) respectively.
Conclusion: CPAP is cost effective compared to all treatments collectively, as well as specifically to OAs and no treatment though with low certainty.
期刊介绍：
Expert Review of Pharmacoeconomics & Outcomes Research (ISSN 1473-7167) provides expert reviews on cost-benefit and pharmacoeconomic issues relating to the clinical use of drugs and therapeutic approaches. Coverage includes pharmacoeconomics and quality-of-life research, therapeutic outcomes, evidence-based medicine and cost-benefit research. All articles are subject to rigorous peer-review.
The journal adopts the unique Expert Review article format, offering a complete overview of current thinking in a key technology area, research or clinical practice, augmented by the following sections:
Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results
Article Highlights – an executive summary of the author’s most critical points.
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