{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:16:21Z","timestamp":1791807381332,"version":"4.3.4"},"reference-count":60,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T00:00:00Z","timestamp":1558051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Movement disorders (MDs) are increasingly being managed with deep brain stimulation (DBS). High\u2010quality economic evaluations (EEs) are necessary to evaluate the cost\u2010effectiveness of DBS. We conducted a systematic review of published EEs of the treatment of MDs with DBS. The review compares and contrasts the reported incremental cost\u2010effectiveness ratios (ICERs) and methodology employed by trial\u2010based evaluations (TBEs) and model\u2010based evaluations (MBEs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MeSH and search terms relevant to \u201cMDs,\u201d \u201cDBS,\u201d and \u201cEEs\u201d were used to search biomedical and economics databases. Studies that used a comparative design to evaluate DBS, including before\u2010after studies, were included. Quality and reporting assessments were conducted independently by 2 authors. Seventeen studies that targeted Parkinson's disease (PD), dystonia, and essential tremor (ET), met our selection criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean scores for methodological and reporting quality were 73% and 76%, respectively. The ICERs for DBS compared with best medical therapy to treat PD patients obtained from MBEs had a lower mean and range compared with those obtained from TBEs ($55,461\u2013$735,192 per quality\u2010adjusted life\u2010year [QALY] vs. $9,301\u2013$65,111 per QALY). Pre\u2010post ICER for DBS to treat dystonia was $64,742 per QALY. DBS was not cost\u2010effective in treating ET compared with focused\u2010ultrasound surgery. Cost\u2010effectiveness outcomes were sensitive to assumptions in health utilities, surgical costs, battery life\u2010span, model time horizons, and the discount rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The infrequent use of randomized, controlled trials to evaluate DBS efficacy, the paucity of data reporting the long\u2010term effectiveness and\/or utility of DBS, and the uncertainty surrounding cost data limit our ability to report cost\u2010effectiveness summaries that are robust.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.12780","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T10:22:39Z","timestamp":1557138159000},"page":"348-358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Cost\u2010Effectiveness of Deep Brain Stimulation With Movement Disorders: A Systematic Review"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4046-9666","authenticated-orcid":false,"given":"Tho Thi Hai","family":"Dang","sequence":"first","affiliation":[{"name":"The University of Queensland, Asia\u2010Pacific Centre for Neuromodulation, Queensland Brain Institute  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rowell","sequence":"additional","affiliation":[{"name":"The University of Queensland, Centre for the Business and Economics of Health  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke B.","family":"Connelly","sequence":"additional","affiliation":[{"name":"The University of Queensland, Asia\u2010Pacific Centre for Neuromodulation, Queensland Brain Institute  Brisbane Queensland Australia"},{"name":"The University of Queensland, Centre for the Business and Economics of Health  Brisbane Queensland Australia"},{"name":"The University of Bologna, Departimento di Sociologia e Diritto dell'Economia  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/309431"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1212\/01.CON.0000348899.02339.9d","article-title":"Overview of common movement disorders","volume":"16","author":"Ostrem JL","year":"2010","journal-title":"Continuum (Minneap Minn)"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70183-8"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2012.12.004"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2010.tb03453.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.ra.2016-0021"},{"key":"e_1_2_7_8_1","unstructured":"Medical Services Advisory Committee. Deep brain stimulation for the symptoms of Parkinson's disease. Australia2006. Report No.: 1092."},{"key":"e_1_2_7_9_1","unstructured":"Medical Services Advisory Committee. Deep brain stimulation for essential tremor and dystonia. Australia2008. Report No.: 1109."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0104926"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2015.11.005"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70093-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.260"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.929"},{"key":"e_1_2_7_15_1","volume-title":"Methods for the Economic Evaluation of Health Care Programmes","author":"Drummond M","year":"2015"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2016.1246961"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2016.1246960"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1332\/174426410X482999"},{"key":"e_1_2_7_20_1","unstructured":"HigginsJPT GreenSE.Cochrane Handbook for Systematic Reviews of Interventionsversion 5.1.0 [updated March 2011]: The Cochrane Collaboration 2011;www.cochrane-handbook.org."},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f1049"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26997"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1403.2005.05233.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26423"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12474"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-002-0711-7"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0159340"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.4.663"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-013-7148-z"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21652"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2014.08.051"},{"key":"e_1_2_7_32_1","first-page":"1","article-title":"Cost\u2010effectiveness of continuous subcutaneous apomorphine in the treatment of Parkinson's disease in the UK and Germany","author":"Walter E","year":"2014","journal-title":"J Med Econ"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26740"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25407"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-6612.2003.tb00482.x"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2015.11.062"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26029"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-005-0640-3"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2006.01548.x"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780198529446.001.0001"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2005.10.023"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1258\/135581906775094235"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10473"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2009.295"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20914"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00007730"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/30.4.299"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1159\/000455863"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002173420703"},{"key":"e_1_2_7_51_1","volume-title":"What Is Cost\u2010Effectiveness","author":"Phillips C","year":"2009"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X07300606"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-015-0309-4"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnint.2011.00019"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26701"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2010.05.006"},{"key":"e_1_2_7_57_1","first-page":"13","article-title":"Interpreting health economics data in Parkinson's disease","volume":"6","author":"Dodel R.","year":"2011","journal-title":"Eur Neurol Rev"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2016.05.028"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2015.05.028"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12550"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2004.75012.x"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmdc3.12780","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.12780","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.12780","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.12780","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:51:24Z","timestamp":1760953884000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.12780"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,17]]},"references-count":60,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1002\/mdc3.12780"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.12780","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,17]]},"assertion":[{"value":"2018-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}