TABLE 1.
Clinical Parameters and Data Sources Used in Decision Analysis
| Variable | Value | Range | Reference |
|---|---|---|---|
| Cost estimates | |||
| Callosotomy | $92 800 | $72 900‐178 800 | Oldham et al, Ped Neurol 2015. |
| VNS | $30 091 | $20 000‐40 000 | De Kinderen et al, Epilepsy Res 2015. Oldham et al, Ped Neurol 2015. |
| VNS infection | N/A | $0‐100 000 | Wide estimate for sensitivity analysis |
| Other VNS complications | N/A | $0‐100 000 | Wide estimate for sensitivity analysis |
| Permanent neurologic deficit | N/A | $0‐500 000 | Wide estimate for sensitivity analysis |
| Reoperation | N/A | $0‐500 000 | Wide estimate for sensitivity analysis |
| Clinical parameters a | |||
| Seizure reduction after CC | 47.0% | 38.0%‐56.0% | Lancman et al, Seizure 2013. |
| Seizure free after CC | 16.0% | 10.0%‐23.0% | Lancman et al, Seizure 2013. |
| Seizure reduction after VNS | 44.1% | 32.3%‐56.0% | Lancman et al, Seizure 2013. |
| Seizure free after VNS | 5.2% | 2.3%‐9.2% | Lancman et al, Seizure 2013. |
| Atonic seizure reduction after CC | 32.0% | 19.0%‐42.0% | Lancman et al, Seizure 2013. |
| Atonic seizure free after CC | 48.0% | 31.0%‐65.0% | Lancman et al, Seizure 2013. |
| Atonic seizure reduction after VNS | 31.3% | 9.3%‐49.6% | Lancman et al, Seizure 2013. |
| Atonic seizure free after VNS | 22.8% | 6.6%‐44.9% | Lancman et al, Seizure 2013. |
| Probability of permanent neurologic deficit | 0.6% | 0.6%‐5.0% | Ye et al, Childs Nerv Sys 2021. Lancman et al, Seizure 2013. |
| Probability of VNS infection | 2.4% | 1.5%‐2.4% | Ye et al, Childs Nerv Sys 2021. |
| Probability of other VNS complications | 1.4% | 1.4%‐2.8% | Ye et al, Childs Nerv Sys 2021. |
| Probability of reoperation after CC | 6.6% | 6.6%‐10.0% | Ye et al, Childs Nerv Sys 2021. |
a
Seizure freedom and >50% seizure reduction were considered as discrete probabilities; thus, the rates of seizure freedom were subtracted from the rate of >50% seizure reduction to calculate the probabilities of seizure freedom and >50% seizure reduction.