{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T21:01:27Z","timestamp":1789938087162,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,25]],"date-time":"2018-10-25T00:00:00Z","timestamp":1540425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to demonstrate how decision\u2010analytic modelling can help to determine circumstances under which surgery may become cost\u2010effective, using septoplasty as an example.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We developed a decision\u2010analytic model comparing septoplasty to non\u2010surgical management for nasal obstruction in adults with a deviated septum. Based on the estimated cost difference between both treatments, we calculated the minimal (a) gain in quality\u2010adjusted life\u2010years, or (b) reduction in productivity losses needed for septoplasty to be cost\u2010effective. Input was derived from literature and publicly available data sources. The time horizon of our model was one year, and the willingness\u2010to\u2010pay per quality\u2010adjusted life\u2010year was \u20ac20\u00a0000, in accordance with current guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cost difference between septoplasty and non\u2010surgical management for nasal obstruction due to a deviated nasal septum was \u20ac2227 per patient from a healthcare perspective (including direct healthcare costs) and \u20ac3288 per patient from an extended perspective (additionally including travel expenses and productivity losses due to poor health). In comparison with non\u2010surgical management, septoplasty needed to gain 0.11 to 0.16 QALYs or save 13 sick days for nasal obstruction. The longer septoplasty's effect lasts, the more time it will have to compensate its extra costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study shows that the known cost difference between treatments can be used as the starting point to determine beneficial effects needed for cost\u2010effectiveness of surgical interventions. The effect required by septoplasty from a healthcare perspective seems potentially achievable, meaning that it would be useful to perform an RCT assessing the actual benefits of septoplasty.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13234","type":"journal-article","created":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T06:56:23Z","timestamp":1538376983000},"page":"53-62","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Septoplasty versus non\u2010surgical management for nasal obstruction due to a deviated nasal septum in adults: A modelling study of cost\u2010effectiveness"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1451-3942","authenticated-orcid":false,"given":"Machteld M. H. 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T.","family":"Hedeman","sequence":"additional","affiliation":[{"name":"Department of Operating Rooms Radboud University Medical Center, Radboud Institute for Health Sciences Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"van Heerbeek","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Radboud University Medical Center, Radboud Institute for Health Sciences Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3095-170X","authenticated-orcid":false,"given":"Maroeska M.","family":"Rovers","sequence":"additional","affiliation":[{"name":"Department of Operating Rooms Radboud University Medical Center, Radboud Institute for Health Sciences Nijmegen The Netherlands"},{"name":"Department of Health Evidence Radboud University Medical Center, Radboud Institute for Health Sciences Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2014.12.002"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-10-9"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin18.016"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2002.00531.x"},{"key":"e_1_2_10_6_1","unstructured":"Ent UK.The British Academic Conference in Otolaryngology (BACO) and the British Association of Otorhinolaryngology \u2013 Head and Neck Surgery (BAO\u2010HNS).Nasal Septal Surgery: ENTUK position paper;2010."},{"key":"e_1_2_10_7_1","unstructured":"Dutch ENT Society. 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