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Cost Efficacy of Rapid Whole Genome Sequencing in the Pediatric Intensive Care Unit.
Sanford Kobayashi, Erica; Waldman, Bryce; Engorn, Branden M; Perofsky, Katherine; Allred, Erika; Briggs, Benjamin; Gatcliffe, Chelsea; Ramchandar, Nanda; Gold, Jeffrey J; Doshi, Ami; Ingulli, Elizabeth G; Thornburg, Courtney D; Benson, Wendy; Farnaes, Lauge; Chowdhury, Shimul; Rego, Seema; Hobbs, Charlotte; Kingsmore, Stephen F; Dimmock, David P; Coufal, Nicole G.
Afiliación
  • Sanford Kobayashi E; Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
  • Waldman B; Rady Children's Institute for Genomic Medicine, San Diego, CA, United States.
  • Engorn BM; Rady Children's Institute for Genomic Medicine, San Diego, CA, United States.
  • Perofsky K; Rady Children's Hospital San Diego, San Diego, CA, United States.
  • Allred E; Rady Children's Institute for Genomic Medicine, San Diego, CA, United States.
  • Briggs B; Rady Children's Hospital San Diego, San Diego, CA, United States.
  • Gatcliffe C; Rady Children's Institute for Genomic Medicine, San Diego, CA, United States.
  • Ramchandar N; Rady Children's Hospital San Diego, San Diego, CA, United States.
  • Gold JJ; Naval Medical Center San Diego, San Diego, CA, United States.
  • Doshi A; McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
  • Ingulli EG; Rady Children's Institute for Genomic Medicine, San Diego, CA, United States.
  • Thornburg CD; Rady Children's Hospital San Diego, San Diego, CA, United States.
  • Benson W; Rady Children's Hospital San Diego, San Diego, CA, United States.
  • Farnaes L; Department of Neuroscience, University of California, San Diego, San Diego, CA, United States.
  • Chowdhury S; Rady Children's Hospital San Diego, San Diego, CA, United States.
  • Rego S; Department of Pediatrics, University of California, San Diego, San Diego, CA, United States.
  • Hobbs C; Rady Children's Hospital San Diego, San Diego, CA, United States.
  • Kingsmore SF; Rady Children's Hospital San Diego, San Diego, CA, United States.
  • Dimmock DP; Department of Pediatrics, University of California, San Diego, San Diego, CA, United States.
  • Coufal NG; Rady Children's Institute for Genomic Medicine, San Diego, CA, United States.
Front Pediatr ; 9: 809536, 2021.
Article en En | MEDLINE | ID: mdl-35141181
The diagnostic and clinical utility of rapid whole genome sequencing (rWGS) for critically ill children in the intensive care unit (ICU) has been substantiated by multiple studies, but comprehensive cost-effectiveness evaluation of rWGS in the ICU outside of the neonatal age group is lacking. In this study, we examined cost data retrospectively for a cohort of 38 children in a regional pediatric ICU (PICU) who received rWGS. We identified seven of 17 patients who received molecular diagnoses by rWGS and had resultant changes in clinical management with sufficient clarity to permit cost and quality adjusted life years (QALY) modeling. Cost of PICU care was estimated to be reduced by $184,846 and a total of 12.1 QALYs were gained among these seven patients. The total cost of rWGS for patients and families for the entire cohort (38 probands) was $239,400. Thus, the net cost of rWGS was $54,554, representing $4,509 per QALY gained. This quantitative, retrospective examination of healthcare utilization associated with rWGS-informed medicine interventions in the PICU revealed approximately one-third of a QALY gained per patient tested at a cost per QALY that was approximately one-tenth of that typically sought for cost-effective new medical interventions. This evidence suggests that performance of rWGS as a first-tier test in selected PICU children with diseases of unknown etiology is associated with acceptable cost-per-QALY gained.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Health_economic_evaluation Aspecto: Patient_preference Idioma: En Revista: Front Pediatr Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Health_economic_evaluation Aspecto: Patient_preference Idioma: En Revista: Front Pediatr Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza