Hailey D, Ohinmaa A; International Society of Technology Assessment in Health Care. Meeting (19th : 2003 : Canmore, Alta.).

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2003; 19: abstract no. 293.

Alberta Heritage Foundation for Medical Research, Suite 1500, 10104 - 103 Avenue, Edmonton, AB T5J 4A7 Canada E-mail: dhailey@ozE-mail.com.au

OBJECTIVES: To inform policy in Alberta on stereotactic radiosurgery (STR) services through assessment of recent literature and a cost model. METHODS: Systematic review of literature on the safety and effectiveness of STR in all applications, using electronic data bases and HTA agency reports. Cost model, using Albertan values, to estimate the investment, operational and maintenance costs of the main STR technologies, and of conventional microsurgery. RESULTS: Some 190 clinical studies of STR were reviewed, of which only 13 were comparative. STR has a useful, though inadequately defined place in treatment of acoustic neuroma, arteriovenous malformations and brain malignancies. Its role in treatment of trigeminal neuralgia, Parkinson's disease and epilepsy is not established. There is increasing use of newer types of stereotactic radiation delivery systems. Cost analysis showed that, compared to microsurgery, an STR unit would need to treat 125 - 140 patients per year to be cost saving. From the perspective of patients and caregivers, STR is cost saving compared to surgery. DISCUSSION: Good quality evidence on the safety and effectiveness of STR remains sparse. A relatively high caseload would be needed if a dedicated STR unit were to achieve cost savings for the Alberta health system. STR should continue to be made available to appropriately selected patients with metastatic disease, arteriovenous malformations and acoustic neuroma; it should not be offered for treatment of Parkinson's disease, trigeminal neuralgia or epilepsy. Any referral of patients for STR should be to centres of excellence, taking account of other appropriate treatment options.

Publication Types:

• Meeting Abstracts

Keywords:

• Alberta
• Arteriovenous Malformations
• Government Agencies
• Humans
• Microsurgery
• Neuroma, Acoustic
• Physical Examination
• Radiosurgery
• Stereotaxic Techniques
• Trigeminal Neuralgia
• methods
• radiotherapy
• surgery
• hsrmtgs

Other ID:

• GWHSR0004526

UI: 102276211

From Meeting Abstracts