J. For the same reason, no consent was obtained. Electroconvulsive therapy (ECT) is a non-medication medical treatment that addresses severe psychiatric symptoms, after trials of medications and psychotherapy have been unsuccessful or a mental health disorder is determined to be severe and acute enough to warrant this intervention. Seamlessly record and store data on a laptop/desktop, hospital server, and the Electronic Health Record as pdfs. With proper diagnosis, treatments and medications are available. Promotional financing available when you pay with CareCredit.  MJ, Williams  et al. Electroconvulsive therapy (ECT) is a highly effective treatment for depression.1 Research indicates that ECT can be significantly more effective than pharmacotherapy, with 50% to 60% of patients achieving rapid remission of depression after a course of ECT compared with 10% to 40% with pharmacotherapy/psychotherapy.2-4 Beyond its immediate clinical effects, ECT is also associated with decreased psychiatric hospitalization rates5,6 and reduced long-term risks of suicide and all-cause mortality.7, Despite these benefits, ECT use remains low. What types of To assess the cost-effectiveness of ECT compared with pharmacotherapy/psychotherapy for treatment-resistant major depressive disorder in the United States.  Q, Quinn In probabilistic sensitivity analysis, the model was run using parameter values drawn at random from distributions reflecting the uncertainty in the estimation of each parameter, ie, second-order uncertainty (Table 1)58; to estimate overall uncertainty, we repeated this process 10 000 times. To address these issues, we developed a decision analytic model to simulate the clinical and economic effects of ECT. ACC/AHA statement on cost/value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and Task Force on Practice Guidelines. A person usually needs six to 12 treatments for this medical therapy to be effective. Those on high deductible health plans or without insurance can shop, compare prices and save.  T, Tandon Health-related quality of life in a clinical trial of ECT followed by continuation pharmacotherapy: effects immediately after ECT and at 24 weeks.  T, Franklin Kennedy  EA, Karnon Interventions  Unsubscribe at anytime. The impact of treatment-resistant depression on health care utilization and costs. In this mathematical modeling analysis integrating data from multiple published sources, offering electroconvulsive therapy as third-line treatment for depression would cost an estimated $54 000 per quality-adjusted life-year gained.  L, Schreiber For US patients with treatment-resistant depression, ECT may be an effective and cost-effective treatment option. It is highly effective, in that the American Psychiatric Association describes it as being effective in about 80% of people with the potentially life-threatening mental illnesses previously described, often in people whose depression or other mental health symptoms have failed to respond to other treatments, like medicines and psychotherapy.  SR,  WV.  PB, Kimball  JT, Weinstein  LJ, Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. ECT is an effective treatment for people of a wide range of ages, from children and adolescents to elderly patients.  P, Perestelo-Pérez Although some observational studies suggest that depression treatment may reduce suicide risk,7 randomized studies have not found a significant effect.47 Hence, we make the conservative assumption that treatment does not affect mortality rates. Bailine Speed of response and remission in major depressive disorder with acute electroconvulsive therapy (ECT): a Consortium for Research in ECT (CORE) report. For patients with 3 or more prior treatment trials, offering ECT later in the course of treatment would still be cost-effective. How ECT works isn't clear, but it's effectiveness is. Consolidated health economic evaluation reporting standards (CHEERS): explanation and elaboration: a report of the ISPOR Health Economic Evaluations Publication Good Reporting Practices Task Force. Centers for Medicare and Medicaid Services.  I. A decision analytic model integrating data on clinical efficacy, costs, and quality-of-life effects of ECT compared with pharmacotherapy/psychotherapy was used to simulate depression treatment during a 4-year horizon from a US health care sector perspective. Strategies with incremental cost-effectiveness ratios of $100 000 per quality-adjusted life-year or less were designated cost-effective. Sienaert  B, Heijnen Sapin On MDsave, the cost of an Electroconvulsive Therapy (ECT) is $1,105. Inpatient psychiatric facility prospective payment system.  L, Vázquez Critical revision of the manuscript for important intellectual content: All authors.  MM, Rush  JC, Tripathi  CE, Fochtmann Factors that influence electroconvulsive therapy referrals: a statewide survey of psychiatrists.  JM, Hawkins Where available data permit, ranges reflect 95% confidence intervals; in other cases, the source of the range is described in subsequent sections. Effect of concomitant pharmacotherapy on electroconvulsive therapy outcomes: short-term efficacy and adverse effects. Over 4 years, ECT was projected to reduce the fraction of time with nonresponse of depression from 50.2% of life-years to 37.1% to 32.9% of life-years, with greater reductions when ECT is offered earlier. Design, Setting, and Participants   et al. Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. Where possible, we have chosen these assumptions to be conservative with respect to ECT’s cost-effectiveness, such as assuming indefinite maintenance ECT use, excluding ECT’s effects on mortality and speed of remission,3,7 and excluding the possibility of greater efficacy with earlier ECT use.10 In addition, our model assumes that transition probabilities between states (eg, relapse probabilities71) do not vary over time.  JA, Chee Given the need for the ECT recipient to receive general anesthesia, medical professionals, usually psychiatrists, administer this medical therapy.  J, Li  T, Koesters  J.  Ultra-brief pulse ECT in bipolar and unipolar depressive disorder: differences in speed of response. In probabilistic sensitivity analysis, we found a 74% to 78% likelihood that at least 1 ECT strategy was cost-effective (ICER ≤$100 000/QALY) depending on the degree of parameter covariance (Table 3). Heijnen By 1940, psychiatrists were using ECT in the United States. Poor health-related quality of life prior to ECT in depressed patients normalizes with sustained remission after ECT. American Psychiatric Association Committe on Electroconvulsive Therapy.  MC, Pasculli Learn to Spot Depression: Symptoms, Warning Signs, Medication, Patient Comments: Electroconvulsive Therapy (ECT) - Side Effects, Patient Comments: Electroconvulsive Therapy (ECT) - Cost, Depression Has Strong Ties to Stroke, Study Finds, For Some, Postpartum Depression Lingers for Years, After Grieving Mother's Death, Teen Helps Others.  J, Amos These reductions translate to mean quality-adjusted survival gains of 0.12 to 0.15 QALYs, at incremental costs of $7300 to $12 000. Physicians often consider if a treatment known as magnetic stimulation therapy is ineffective.  ML, Edlund  N, Hunter We next assessed incorporating an absolute mortality reduction of 0.07% for patients with remission/response of depression, reflecting 1 estimate of the reduction in suicide mortality with effective treatment.61 Finally, we simulated using maintenance ECT only after 1 relapse with maintenance pharmacotherapy alone; annual relapse probability with maintenance pharmacotherapy alone is set to 51.1%.62, To provide external validation of our model, we compared model-generated outcomes with independent published results. Acquisition, analysis, or interpretation of data: All authors. Efficacy of electroconvulsive therapy in bipolar versus unipolar major depression: a meta-analysis.  S, Berndt Finally, in scenario sensitivity analysis, we assessed alternative approaches to modeling pharmacotherapy efficacy, depression cost, and maintenance ECT use. Hornberger  WV, Rosenquist Role of the Funder/Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.  RM. Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: a systematic review and meta-analysis.

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