{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:11:40Z","timestamp":1782861100912,"version":"3.54.5"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Postoperative delirium (POD) arises among older surgical patients. Screening followed by prevention efforts are recommended. A risk prediction tool called PIPRA plus has been developed, yet its performance and whether adoption into health services is cost-effective are unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To estimate the expected change to \u2018total costs\u2019 and \u2018health benefits\u2019 measured by quality adjusted life years (QALYs) from a decision to adopt PIPRA plus for screening purpose to find at-risk individuals who are then offered nonpharmacological interventions to reduce risks of POD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cost-effectiveness modelling study that draws on a range of relevant data sources.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Swiss healthcare system.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects<\/jats:title>\n                  <jats:p>Surgical inpatients aged 60 or older, excluding cardiac and intracranial surgeries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A decision tree model was used to capture the events likely to impact on cost and health outcomes. Information was harvested from a prospective before\u2013after study done in Switzerland and augmented with other data. Probabilistic sensitivity analysis was undertaken to reveal the probability that adoption was cost-effective against a stated maximum willingness to pay threshold for decision-making in Switzerland.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients in both phases of the study were similar. Costs were lower by 2898\u00a0CHF (SD\u00a01050) per patient with the adoption of the risk screening tool and there was a modest gain to health benefits of 0.01\u00a0QALY (SD\u00a00.026). There was a 99.7% probability that adoption would be cost-saving and 91% probability that adoption would be cost-effective.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We provide early-stage evidence that a decision to adopt the risk screening tool and offer risk-reducing interventions could be cost-effective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaf122","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:04:17Z","timestamp":1747170257000},"source":"Crossref","is-referenced-by-count":4,"title":["Cost-effectiveness of adopting a postoperative delirium risk prediction tool with nonpharmacological delirium prevention interventions for surgical patients"],"prefix":"10.1093","volume":"54","author":[{"given":"Nicholas","family":"Graves","sequence":"first","affiliation":[{"name":"Duke-NUS Graduate Medical School \u2013 HSSR , 8 College Road 01-38 , 169857 Singapore ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6nke","family":"B\u00f6ttger","sequence":"additional","affiliation":[{"name":"Hirslanden Klinik Hirslanden , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Zozmann","sequence":"additional","affiliation":[{"name":"Kusnacht Practice , Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Franziska","sequence":"additional","affiliation":[{"name":"Hirslanden Klinik Hirslanden , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reto","family":"Stocker","sequence":"additional","affiliation":[{"name":"Hirslanden Klinik Hirslanden , Zurich 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