title: Cost-effectiveness analysis of main diagnosis tools in women with overactive bladder. Clinical history, micturition diary and urodynamic study.
abstract: OBJECTIVE
  The aim of the present clinical research is to analyze, in the light of the best scientific evidence, the performance and the cost of the main diagnostic tools for overactive bladder (OAB).
  
  
  METHODS
  It is an exploratory transversal study in which 199 women diagnosed of OAB between 2006 and 2008 were selected and underwent to following prospective analyses: physical examination, urine analysis, micturition diary (MD) and urodynamic study (UDS). A percentage of 80% was assumed as highly sensitive and a diagnostic difference among tests of 10% would be considered clinically relevant. Tests' sensitivity for diagnosis of OAB was statistically established by two ways: isolated and combined. Besides, the direct and indirect costs of these tests performance were conducted. Cost-effectiveness study of clinical history (CH), MD and US for the diagnosis of OAB was performed.
  
  
  RESULTS
  Overall sensitivity for OAB diagnosis is low for the 3 tests used in isolated way, whilst the combination of any two tests shows good overall sensitivity. The combination of CH and MD has appeared as the most cost-effective alternative to OAB diagnosis.
  
  
  CONCLUSIONS
  For OAB diagnosis, CH-DM combination shows the same sensitivity than the association of either of them with the UDS, but unlike to these, it shows the lowest cost.
authors.affiliation: Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: urologia@lopez-fando.com.
authors.forename: L
authors.initials: L
authors.lastname: López-Fando
authors.affiliation: Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: D
authors.initials: D
authors.lastname: Carracedo
authors.affiliation: Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Jiménez
authors.affiliation: Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Gómez de Vicente
authors.affiliation: Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: Martínez
authors.affiliation: Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Gómez-Cañizo
authors.affiliation: Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: V
authors.initials: V
authors.lastname: Gómez
authors.affiliation: Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Burgos
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D019937:Diagnostic Techniques and Procedures / Q000191:economics; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D011446:Prospective Studies; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000191:economics*; D014554:Urination; D014563:Urodynamics
keywords: Cost-effectiveness; Coste-efectividad; Diario miccional; Micturition diary; Overactive bladder; Vejiga hiperactiva