{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:09:20Z","timestamp":1782166160161,"version":"3.54.5"},"reference-count":51,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to evaluate the long\u2010term cost\u2010effectiveness of sacral neuromodulation in the treatment of severe faecal incontinence as compared with symptomatic management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the public health field, a micro\u2010costing evaluation method was conducted from the perspectives of the health system and the society. The incremental cost\u2010effectiveness ratio was used as a decision index, and we considered various scenarios to evaluate the impact of the cost of symptomatic management and percutaneous nerve evaluation success rate in its calculation. Clinical data were retrieved from a consecutive cohort of 93 patients with severe faecal incontinence undergoing sacral neuromodulation after a failure of conservative (pharmacological and biofeedback) and\/or surgical (sphincteroplasty) first\u2010line treatments were considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The long\u2010term incremental cost\u2010effectiveness ratio comparing sacral neuromodulation versus symptomatic management was 14347\u20ac\/QALY and 28523\u20ac\/QALY from the societal and health service provider's perspectives, respectively. If the definitive pulse generator implant success rate was 100%, incremental cost\u2010effectiveness would correspond to 6831\u20ac\/QALY and 16761\u20ac\/QALY, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sacral neuromodulation may be considered a cost\u2010effective technique in the long\u2010term treatment of severe faecal incontinence from the societal and health care sector perspectives. Improving patient selection and determining the predictive outcome factors for successful sacral neuromodulation in the treatment of faecal incontinence would improve cost\u2010effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16692","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T08:31:47Z","timestamp":1691397107000},"page":"1821-1831","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long\u2010term cost\u2010effectiveness analysis of sacral neuromodulation in the treatment of severe faecal incontinence"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6060-391X","authenticated-orcid":false,"given":"Mario J.","family":"de Miguel\u00a0Valencia","sequence":"first","affiliation":[{"name":"General Surgery Service Hospital Reina Sof\u00eda de Tudela  Tudela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0207-4137","authenticated-orcid":false,"given":"Juan M.","family":"Cabas\u00e9s\u00a0Hita","sequence":"additional","affiliation":[{"name":"Department of Economics Public University of Navarre (UPNA)  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5320-8732","authenticated-orcid":false,"given":"Eduardo","family":"S\u00e1nchez\u00a0Iriso","sequence":"additional","affiliation":[{"name":"Department of Economics Public University of Navarre (UPNA)  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Oteiza\u00a0Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit Hospital Universitario de Navarra  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u00f1aki","family":"Alberdi\u00a0Iba\u00f1ez","sequence":"additional","affiliation":[{"name":"General Surgery Service Hospital Reina Sof\u00eda de Tudela  Tudela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"\u00c1lvarez\u00a0L\u00f3pez","sequence":"additional","affiliation":[{"name":"General Surgery Service Hospital Reina Sof\u00eda de Tudela  Tudela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor","family":"Ortiz\u00a0Hurtado","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit Hospital Universitario de Navarra  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario J.","family":"de Miguel\u00a0Velasco","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit Hospital Universitario de Navarra  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","volume-title":"Methods for the economic evaluation of health care Programmes","author":"Drummond MF","DOI":"10.1093\/oso\/9780198529446.001.0001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.12195"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.12844"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9740"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.10.038"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234823"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050307"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0514-5"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02237236"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaceta.2015.08.007"},{"issue":"7","key":"e_1_2_11_13_1","first-page":"422","article-title":"Economic burden of long\u2010term treatment of severe fecal incontinence","volume":"100","author":"Miguel Valencia MJ","year":"2022","journal-title":"Cir Esp"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520510012172"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31823dfd6d"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780198526629.001.0001"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17113823"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.947"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1008"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0213-9111(02)71933-X"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2018.1447828"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2004.75003.x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3633"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaceta.2019.06.007"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.635"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.23938\/ASSN.0922"},{"key":"e_1_2_11_27_1","first-page":"1155","article-title":"Economic evaluation of sacral nerve stimulation for faecal incontinence","volume":"95","author":"Dudding TC","year":"2008","journal-title":"BrJSurg"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6140"},{"key":"e_1_2_11_29_1","first-page":"1411","article-title":"Outcome and cost analysis of sacral nerve stimulation for faecal incontinence","volume":"93","author":"Hetzer FH","year":"2006","journal-title":"BrJSurg"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079908X260970"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181f46309"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318210f1f4"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12002"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284818802562"},{"key":"e_1_2_11_35_1","volume-title":"Medical services advisory Commite (MSAC). Application 1077, assessment report","author":"Sacral nerve stimulation for faecal incontinence","year":"2005"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-3-47"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02237089"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2018.1443810"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-5050-9"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4183"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-019-00481-8"},{"issue":"50","key":"e_1_2_11_42_1","first-page":"1","article-title":"Supplementary evidence to support the National Institute for health and care Excellence's consideration of affordability and cost\u2010effectiveness in its recommendations: findings from a rapid review of the literature","volume":"24","author":"Soares M","year":"2020","journal-title":"Health Technol Assess"},{"key":"e_1_2_11_43_1","volume-title":"Guide to the methods of technology appraisal 2013","author":"National Institute for Health and Clinical Excellence (NICE)","year":"2013"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.zefq.2014.06.016"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-015-0336-1"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540140060028"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaceta.2010.02.006"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2008.01.076"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12695"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-019-01205-z"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23008"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000576"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.16692","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T19:29:02Z","timestamp":1700681342000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.16692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,7]]},"references-count":51,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/codi.16692"],"URL":"https:\/\/doi.org\/10.1111\/codi.16692","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,7]]},"assertion":[{"value":"2022-10-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}