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An Economic Evaluation of a Web-Based Management Support System for Children With Urinary Incontinence: The eADVICE Trial.
Von Huben, Amy; Howell, Martin; Richards, Deborah; Hamilton, Sana; Howard, Kirsten; Teixeira-Pinto, Armando; Craig, Jonathan C; Seton, Chris; Waters, Karen; Deshpande, Aniruddh; Scott, Karen M; Caldwell, Patrina H Y.
Affiliation
  • Von Huben A; School of Public Health, The University of Sydney, Sydney, Australia.
  • Howell M; Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia.
  • Richards D; School of Public Health, The University of Sydney, Sydney, Australia.
  • Hamilton S; Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia.
  • Howard K; School of Computing, Macquarie University, Sydney, Australia.
  • Teixeira-Pinto A; The Children's Hospital at Westmead, Sydney, Australia.
  • Craig JC; School of Public Health, The University of Sydney, Sydney, Australia.
  • Seton C; Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia.
  • Waters K; School of Public Health, The University of Sydney, Sydney, Australia.
  • Deshpande A; College of Medicine and Public Health, Flinders University, Adelaide, Australia.
  • Scott KM; The Children's Hospital at Westmead, Sydney, Australia.
  • Caldwell PHY; The Children's Hospital at Westmead, Sydney, Australia.
J Urol ; 212(1): 185-195, 2024 Jul.
Article in En | MEDLINE | ID: mdl-38603582
ABSTRACT

PURPOSE:

Children who require specialist outpatient care typically wait substantial periods during which their condition may progress, making treatment more difficult and costly. Timely and effective therapy during this period may reduce the need for lengthy specialist care. This study evaluated the cost-effectiveness of an individualized, evidence-informed, web-based program for children with urinary incontinence awaiting a specialist appointment (Electronic Advice and Diagnosis Via the Internet following Computerized Evaluation [eADVICE]) compared to usual care. eADVICE was supervised by a primary physician and delivered by an embodied conversational agent. MATERIALS AND

METHODS:

A trial-based cost-effectiveness analysis was performed from the perspective of the health care funder as a substudy of eADVICE, a multicenter, waitlist-controlled, randomized trial. Outcomes measures were incremental cost per incremental change in continence status and quality of life on an intention-to-treat basis. Uncertainty was examined using cost-effectiveness planes, scenarios, and 1-way sensitivity analyses. Costs were valued in 2021 Australian dollars.

RESULTS:

The use of eADVICE was found to be cost saving and beneficial (dominant) over usual care, with a higher proportion of children dry over 14 days at 6 months (risk difference 0.13; 95%CI 0.02-0.23, P = .03) and mean health care costs reduced by $188 (95%CI $61-$315) per participant.

CONCLUSIONS:

An individualized, evidence-informed, web-based program delivered by an embodied conversational agent is likely cost saving for children with urinary incontinence awaiting a specialist appointment. The potential economic impact of such a program is favorable and substantial, and may be transferable to outpatient clinic settings for other chronic health conditions.
Subject(s)
Key words

Full text: 1 Database: MEDLINE Main subject: Urinary Incontinence / Cost-Benefit Analysis Limits: Adolescent / Child / Female / Humans / Male Country/Region as subject: Oceania Language: En Journal: J Urol Year: 2024 Type: Article Affiliation country: Australia

Full text: 1 Database: MEDLINE Main subject: Urinary Incontinence / Cost-Benefit Analysis Limits: Adolescent / Child / Female / Humans / Male Country/Region as subject: Oceania Language: En Journal: J Urol Year: 2024 Type: Article Affiliation country: Australia