title: Implantable Doppler in monitoring free flaps: a cost-effectiveness analysis based on a systematic review of the literature.
abstract: OBJECTIVE
  The purpose of this paper is to evaluate the efficacy and cost-effectiveness of the implantable Doppler system based on the analysis of the available scientific literature and clinical and cost data available in our hospital. The results of this system are compared to those of conventional free flap monitoring methods.
  
  
  METHODS
  The literature published between 1991 and 2011 was systematically reviewed. All available cost data were collected and several simulations were performed. A retrospective assessment of the efficacy of conventional methods in our hospital was also conducted.
  
  
  CONCLUSIONS
  The implantable Doppler system is more effective than the conventional methods used to monitor free flap perfusion. The mean flap salvage rate with the implantable Doppler was 21 percentage points higher (81.4 vs. 60.4). The excess cost compared to conventional methods was about CAD 120 per patient (about EUR 94). However, this excess cost can be compensated or even reversed, depending on the initial flap salvage rate in the health facility and the type of free flap (buried vs. non-buried).
authors.affiliation: Unité d'évaluation des technologies et des modes d'intervention en santé (UÉTMIS), hôpital Fleurimont, centre hospitalier universitaire de Sherbrooke (CHUS), 12(e), avenue Nord, 3001, Sherbrooke, J1H 5N4 Quebec, Canada. tpoder.chus@ssss.gouv.qc.ca
authors.forename: T G
authors.initials: TG
authors.lastname: Poder
authors.forename: P-H
authors.initials: PH
authors.lastname: Fortier
mesh_terms: D003362:Cost-Benefit Analysis; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D008991:Monitoring, Physiologic / Q000191:economics / Q000295:instrumentation* / Q000379:methods*; D019736:Prostheses and Implants; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler / Q000191:economics* / Q000295:instrumentation*