Fig 1.
(a) Decision Tree and (b) health states for MRI-guided laser interstitial thermal therapy (MRgLITT) versus epilepsy surgery.
Table 1.
Probability parameters for model.
Table 2.
Cost parameters for model.
Table 3.
Utility parameters for model.
Table 4.
Base case analysis.
Fig 2.
Tornado diagram from one-way sensitivity analyses showing the incremental net monetary benefit (NMB) of MRgLITT versus surgery.
Influential parameters include utility of disabling seizures state after MRgLITT as well as surgery and without complication, probability of returning to disabling seizures from seizure-free state 5 years after surgery as well as MRgLITT, probability of becoming seizure-free from disabling seizures state 5 years after surgery as well as MRgLITT, and utility of seizure-free after surgery without complication. (SF: seizure-free; DS: disabling seizures).
Fig 3.
(a) Incremental cost-effectiveness ratio of MRgLITT vs. surgery scatter plot from probabilistic sensitivity analysis shows that 51.4% of the iterations are above the cost-effectiveness threshold (CET) of $50,000/QALY. (b) The cost-effectiveness acceptability curve (CEAC) demonstrates that for the range of cost-effectiveness threshold (CET) from $0 to $120,000/QALY, surgery is the preferred strategy in more than 50.0% of iterations.
Table 5.
Scenario analyses of different subsequent treatment options following an unsuccessful MRgLITT.