title: Using a cost-benefit analysis to estimate outcomes of a clinical treatment guideline: testing theBrain Trauma Foundation guidelines for the treatment of severe traumatic brain injury.
abstract: BACKGROUND
  A decade after promulgation of treatment guidelines by the Brain Trauma Foundation (BTF), few studies exist that examine the application of these guidelines for severe traumatic brain injury (TBI) patients. These studies have reported both cost savings and reduced mortality.
  
  
  METHODS
  We projected the results of previous studies of BTF guideline adoption to estimate the impact of widespread adoption across the United States. We used surveillance systems and national surveys to estimate the number of severely injured TBI patients and compared the lifetime costs of BTF adoption to the current state of treatment.
  
  
  RESULTS
  After examining the health outcomes and costs, we estimated that a substantial savings in annual medical costs ($262 million), annual rehabilitation costs ($43 million) and lifetime societal costs ($3.84 billion) would be achieved if treatment guidelines were used more routinely. Implementation costs were estimated to be $61 million. The net savings were primarily because of better health outcomes and a decreased burden on lifetime social support systems. We also estimate that mortality would be reduced by 3,607 lives if the guidelines were followed.
  
  
  CONCLUSIONS
  Widespread adoption of the BTF guidelines for the treatment of severe TBI would result in substantial savings in costs and lives. The majority of cost savings are societal costs. Further validation work to identify the most effective aspects of the BTF guidelines is warranted.
authors.affiliation: Division of Injury Response, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. mfaul@cdc.gov
authors.forename: Mark
authors.initials: M
authors.lastname: Faul
authors.forename: Marlena M
authors.initials: MM
authors.lastname: Wald
authors.forename: Wesley
authors.initials: W
authors.lastname: Rutland-Brown
authors.forename: Ernest E
authors.initials: EE
authors.lastname: Sullivent
authors.forename: Richard W
authors.initials: RW
authors.lastname: Sattin
mesh_terms: D001930:Brain Injuries / Q000191:economics / Q000453:epidemiology / Q000534:rehabilitation; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D023261:Glasgow Outcome Scale; D006801:Humans; D017410:Practice Guidelines as Topic; D011336:Probability; D014481:United States / Q000453:epidemiology