Background

The optimal diagnostic strategy for patients with psychiatric and insomnia disorders has not been established yet.

Purpose

The purpose of this study was to perform cost-effectiveness analysis of six neuroimaging technologies in diagnosis of patients with psychiatric and insomnia disorders.

Methods

An economic evaluation study was conducted in three parts, including a systematic review for determining diagnostic accuracy, a descriptive cross-sectional study with Activity-Based Costing (ABC) technique for tracing resource consumption, and a cost-effectiveness analysis using a short-term decision-analytic model.

Results

In the first phase, 93 diagnostic accuracy studies were included in the systematic review. The accumulated results (meta-analysis) showed that the highest diagnostic accuracy for psychiatric and insomnia disorders was attributed to PET (sensitivity of 90% and specificity of 80%) and MRI (sensitivity of 76% and specificity of 78%) respectively. In the second phase of the study, we calculated the cost of each technology. The results showed that MRI has the lowest cost. Based on the results in the model of cost-effectiveness sMRI ($ 50.08 per accurate diagnosis) and MRI ($ 58.54 per accurate diagnosis) were more cost-effective neuroimaging technologies.

Conclusion

In psychiatric disorders, no single strategy was characterized by both low cost and high accuracy. However, MRI and PET scan had lower cost and higher accuracy for psychiatric disorders, respectively. MRI was the least costly with the highest diagnostic accuracy in insomnia disorders. Based on our model, sMRI in psychiatric disorders and MRI in insomnia disorders were the most cost-effective technologies.

中文翻译：

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神经影像技术在精神疾病和失眠症管理中的成本效益：荟萃分析和前瞻性成本分析

背景

精神障碍和失眠障碍患者的最佳诊断策略尚未确定。

目的

本研究的目的是对六种神经影像技术在精神疾病和失眠障碍患者的诊断中进行成本效益分析。

方法

一项经济评价研究分为三个部分进行，包括确定诊断准确性的系统评价、使用基于活动的成本计算 (ABC) 技术跟踪资源消耗的描述性横断面研究，以及使用短期成本效益分析的成本效益分析。决策分析模型。

结果

在第一阶段，系统评价中纳入了 93 项诊断准确性研究。累积结果（荟萃分析）显示，对精神疾病和失眠障碍的最高诊断准确率分别归因于 PET（敏感性为 90%，特异性为 80%）和 MRI（敏感性为 76%，特异性为 78%）。在研究的第二阶段，我们计算了每种技术的成本。结果表明，MRI 的成本最低。根据成本效益模型中的结果，sMRI（每次准确诊断 50.08 美元）和 MRI（每次准确诊断 58.54 美元）是更具成本效益的神经影像技术。

结论

在精神疾病中，没有一种策略同时具有低成本和高准确性的特点。然而，MRI 和 PET 扫描分别对精神疾病具有较低的成本和较高的准确性。MRI 是成本最低、失眠症诊断准确率最高的方法。根据我们的模型，精神疾病的 sMRI 和失眠症的 MRI 是最具成本效益的技术。