Value-Based Analysis of Virtual Versus Traditional Surgical Planning for Orthognathic Surgery
Value-Based Analysis of Virtual Versus Traditional Surgical Planning for Orthognathic Surgery
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DOI：
10.1097/scs.0000000000006426
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发表时间：
2020-07-01
影响因子：
0.9
通讯作者：
Taylor, Jesse A.
中科院分区：
文献类型：
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作者：
Lin, Lawrence O.;Kalmar, Christopher L.;Taylor, Jesse A.
背景：在正颌手术中，虚拟手术计划（VSP）正逐渐取代传统手术计划（TSP）。然而，对VSP成本的担忧延缓了这项技术的采用。本研究探讨了VSP与TSP在整个临床护理连续体中的临床价值。方法：对某三级儿科医院2005 - 2016年接受上颌骨手术的患者进行回顾性队列研究。临床价值，定义为每单位成本的患者结果，分析两组之间的适当统计。结果：VSP组（n = 19）和TSP组（n = 10）的住院时间、并发症发生率、再入院率和术后正畸治疗时间具有统计学意义相似（P = 0.518, P > 0.999, P > 0.999, P = 0.812）。上颌下颌骨VSP手术的手术时间较短（P = 0.052）。TSP组和VSP组住院总费用差异有统计学意义（P = 0.160）。TSP组和VSP组的用药、实验室和检测、房费在统计学上也相似（P = 0.169、P = 0.953和P = 0.196）。结论：使用TSP或VSP的上颌下颌骨手术的索引患者结果和费用在统计学上相似，这使我们得出结论，这两种方法具有相似的临床价值。这一回顾性分析应遵循前瞻性数据，为患者和保险公司提供使用TSP和VSP的临床价值的最佳估计。
Background: In orthognathic surgery, virtual surgical planning (VSP) is gaining popularity over traditional surgical planning (TSP); however, concerns about cost of VSP have slowed adoption of this technology. This study investigates the clinical value of VSP versus TSP over the entire clinical care continuum. Methods: Retrospective cohort study was conducted for patients undergoing maxillomandibular surgery between 2005 and 2016 at a tertiary pediatric hospital. Clinical value, defined as patient outcomes per unit cost, was analyzed between the 2 groups with appropriate statistics. Results: The VSP (n = 19) and TSP (n = 10) cohorts had statistically similar hospital lengths of stay, rates of complications, readmissions, and duration of postoperative orthodontic treatment (P = 0.518, P > 0.999, P > 0.999, P = 0.812, respectively). VSP maxillomandibular procedures trended towards shorter operative times (P = 0.052). Total hospital charges were statistically similar between the TSP and VSP cohorts (P = 0.160). Medication, laboratory and testing, and room charges were also statistically similar between the TSP and VSP cohorts (P = 0.169, P = 0.953, and P = 0.196 respectively). Conclusions: Indexed patient outcomes and costs incurred for maxillomandibular procedures were statistically similar between those utilizing TSP or VSP leading us to conclude that these 2 methods are associated with similar clinical value. This retrospective analysis should be followed with prospective data to give patients and insurers the best estimate of clinical value utilizing TSP and VSP.