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Análisis de costo – efectividad diagnóstica del uso de tomografía computarizada comparada con la resonancia magnética, como primera modalidad diagnóstica en pacientes con cefalea de origen no traumático usuarios del Hospital Universitario Nacional de Colombia hasta el año 2019
dc.rights.license | Atribución-NoComercial 4.0 Internacional |
dc.contributor.advisor | Lozano Castillo, Alfonso Javier |
dc.contributor.advisor | Ruiz Parra, Ariel Iván |
dc.contributor.advisor | Diaz Rojas, Jorge Augusto |
dc.contributor.author | Ruiz Angel, Iván David |
dc.date.accessioned | 2021-01-18T19:52:19Z |
dc.date.available | 2021-01-18T19:52:19Z |
dc.date.issued | 2020-10-25 |
dc.identifier.citation | Ruiz-Angel I.; Lozano-Castilla JA.; Ruiz-Parra AI.; Diaz-Rojas, JA. Análisis de costo – efectividad diagnóstica del uso de Tomografía Computarizada comparada con la Resonancia Magnética, como primera modalidad diagnóstica en pacientes con cefalea de origen no traumático usuarios del Hospital Universitario Nacional de Colombia hasta el año 2019. 2020. |
dc.identifier.uri | https://repositorio.unal.edu.co/handle/unal/78799 |
dc.description.abstract | La cefalea es uno de los diagnósticos por los que con mayor frecuencia se solicitan imágenes diagnósticas del encéfalo. Hasta el momento, los pocos análisis de costo efectividad acerca de cuál es mejor estudio inicial (una tomografía o una resonancia) se basan en pacientes de consulta externa y además no se encuentran estudios locales en Colombia. Se incluyeron pacientes con cefalea no traumática que consultaron entre agosto y noviembre de 2019 y se analizó el número y tipo de exámenes que fueron realizados hasta llegar a un diagnóstico de precisión, así como, el costo de estos estudios. Se encontró que, en los pacientes con cefalea no traumática, que inician su estudio por tomografía computarizada, se logra el diagnóstico de precisión en el 59% de los casos con esta sola imagen; el porcentaje restante, requiere estudios adicionales. Con la resonancia magnética, por otra parte, se realiza el diagnóstico con una sola imagen en el 90% de los casos. La diferencia en el costo promedio de estos exámenes es menor de $378.000.00 COP. Según los análisis probabilísticos con mil iteraciones la resonancia magnética como imagen inicial es la opción más costo-efectiva en el estudio de la cefalea no traumática, en todos los escenarios en los que la disponibilidad a pagar desde la perspectiva del tercer pagador sea igual o mayor a $250.000.00 COP. El escenario en el que se realizó el estudio es un hospital de cuarto nivel con alta prevalencia de patologías complicadas y pacientes con comorbilidades, lo cual debe considerarse en el momento de generalizar los resultados. |
dc.description.abstract | Headache is one of the symptoms for which diagnostic images of the brain are most frequently requested. So far, the few cost-effective studies asking which is the best initial study (a tomography or an MRI) are based on outpatients, and there are no local studies in Colombia. Patients were collected from August to November 2019 looking for the number and type of images that were performed, to reach an accurate diagnosis, as well as the cost of these studies. It was found that patients with non-traumatic headache, who started by tomography as the first image, reach a diagnosis in 59% of the cases with only one image; while in the remaining percentage, require additional studies. On the other, with resonance, a precise diagnosis is stablished in 90% of the cases, with only one image. The differences in the average cost of these studies is less than $378,000 COP. According to the probabilistic analyzes with a thousand iterations, MRI is the most cost-effective option in the study of non-traumatic headache, in all the scenarios in which this willing to pay is equal or more than $250.000.00 COP. The setting in which the study was carried out is a fourth-level hospital with a high prevalence of complicated pathologies and patients with comorbidities, which should be considered when generalizing the results. |
dc.format.extent | 93 |
dc.format.mimetype | application/pdf |
dc.language.iso | spa |
dc.rights | Derechos reservados - Universidad Nacional de Colombia |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ |
dc.subject.ddc | 610 - Medicina y salud |
dc.title | Análisis de costo – efectividad diagnóstica del uso de tomografía computarizada comparada con la resonancia magnética, como primera modalidad diagnóstica en pacientes con cefalea de origen no traumático usuarios del Hospital Universitario Nacional de Colombia hasta el año 2019 |
dc.type | Otro |
dc.rights.spa | Acceso abierto |
dc.description.additional | Línea de Investigación: Neuroimágenes |
dc.type.driver | info:eu-repo/semantics/other |
dc.type.version | info:eu-repo/semantics/acceptedVersion |
dc.publisher.program | Bogotá - Medicina - Especialidad en Radiología e Imágenes Diagnósticas |
dc.description.degreelevel | Especialidades Médicas |
dc.publisher.branch | Universidad Nacional de Colombia - Sede Bogotá |
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dc.rights.accessrights | info:eu-repo/semantics/openAccess |
dc.subject.proposal | Costo Efectividad |
dc.subject.proposal | Cost Effectiveness |
dc.subject.proposal | Tomografía por Rayos X |
dc.subject.proposal | Tomography |
dc.subject.proposal | Imagen por resonancia magnética |
dc.subject.proposal | X-Ray Computed |
dc.subject.proposal | Magnetic Resonance Imaging |
dc.subject.proposal | Cefalea |
dc.subject.proposal | Headache |
dc.subject.proposal | TAC |
dc.type.coar | http://purl.org/coar/resource_type/c_1843 |
dc.type.coarversion | http://purl.org/coar/version/c_ab4af688f83e57aa |
dc.type.content | Text |
oaire.accessrights | http://purl.org/coar/access_right/c_abf2 |
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