Table 23:
Clinical Effectiveness Parameters Used in the Economic Model
| Parameter | Value | Assumption | Source |
|---|---|---|---|
| Improvement Post-surgery (DBS, MRgFUS, RF) | |||
| Percentage of patients with marked improvement | 53% | DBS, MRgFUS, and RF are equally effective | Elias et al, 201638; expert opinion |
| Percentage of patients with mild to moderate improvement | 47% | ||
| Probability of Recurrencea (MRgFUS, RF) | |||
| Year 1 | 8.9% | MRgFUS and RF have the same recurrence rate; calculation based on a 5-year recurrence rate of 25% | Elias et al, 201638; expert opinion |
| Years 2–5 | 4.7% | Hirai et al, 198373; expert opinion | |
| Probability of Recurrencea (DBS) | |||
| Years 1–5 | 0% | Tremor recurrence following DBS can be controlled by adjusting the stimulation level of the device (reprogramming) and does not require reoperation | Tasker et al, 199864; expert opinion |
| Probability of Reoperation After Recurrence (MRgFUS or RF) | |||
| Years 1–5 | 40% | The probability of reoperation is the same for MRgFUS and RF | Elias et al, 201638 |
Abbreviations: DBS, deep brain stimulation; MRgFUS, magnetic resonance-guided focused ultrasound; RF, radiofrequency thalamotomy.
a
Recurrence refers to diminished tremor control to the point of requiring reoperation.