Cost-Effectiveness of MRI-Based Identification of Presymptomatic Autism in a High-Risk Population

Frontiers in Psychiatry
Ian O WilliamsonCarlisle Ford Runge

Abstract

Biological siblings of children with autism spectrum disorder (ASD) have increased risk of receiving an ASD diagnosis. In the U.S., most children with ASD are diagnosed after the optimal age to initiate early intervention which can reduce symptom severity and improve outcomes. Recent evidence suggests magnetic resonance imaging (MRI) in the first year of life can predict later diagnostic status in high-risk siblings. We investigated whether MRI-based screening is a cost-effective method for assigning early intervention. A hybrid decision tree/Markov model was used to evaluate two MRI-based screening strategies at 6 and 12 months of age. Primary outcomes were costs in U.S. dollars and quality-adjusted life years (QALYs). Results were reported as incremental cost-effectiveness ratios (ICERs). Costs were estimated from societal, health care, and educational perspectives. One-way and probabilistic sensitivity analyses were performed. From a societal perspective, the ICER for MRI-based screening at 6 months was $49,000 per QALY when compared to the status quo, implying that such screening is cost-effective at willingness-to-pay (WTP) thresholds of $50,000-$100,000 per QALY. From the health care and educational perspectives, the ICER...Continue Reading

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Citations

Apr 8, 2021·Journal of Child Psychology and Psychiatry, and Allied Disciplines·Birkan TunçUNKNOWN IBIS Network
Oct 17, 2021·Journal of Neurodevelopmental Disorders·Rebecca GrzadzinskiJoseph Piven

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