TABLE 2

Probabilities and Costs

BaseRangeaRef No.
Patient cohorts
    History of ALTE0.024NA14
    Unexplained scalp bruising on ED examination0.24NA13
Probabilities
    Medical perspective
        False-negative initial head CT reading0.080.011–0.1522, 23
        False-positive initial head CT reading0.014b0.0–0.051, 16
        Protective placement after report of any iTBIc0.97b0.9–1.019, 21
        Subsequent iTBI without protective placementd5, 1517
            Probability over 47 wk0.30.26–0.45
            Weekly rate0.00760.0058–0.0848
        Accurate subsequent iTBI diagnosis0.690.5–0.9b8
        Disability at 1 y from subsequent iTBI0.460.29–0.63b6, 7
        Fatality from subsequent iTBI0.150.053–0.176, 7
    Added for societal perspective
        Foster placement after report of any iTBI0.630.48–0.683, 12, 30, 31
Costs, $e
    Medical perspective
        Unsedated noncontrast head CT236169–38933
        ED visit, level 4 or 512688–25433
        Acute medical costs for false-positive CTf381294–65933
        Acute medical costs for initial iTBIg2956597–975634
        Acute medical costs for mild iTBIh97562956–22 78434
        Acute medical costs for severe iTBIi22 7849756–166 49534
        Acute medical costs for fatal iTBIj9756597–166 49534
        Chronic medical costs in all childrenk8/wk7–2536
        Chronic medical costs after severe iTBIl92/wk91–25736
    Added for societal perspective
        Acute child abuse investigation costs33842000–10 000b37
        Inhome protection services after iTBI70/wk35–210b38
        Out-of-home foster care after iTBI472/wk214–140739
  • NA indicates not applicable.

  • a Triangular distributions used in Monte Carlo sensitivity analysis; base case is likeliest value.

  • b Assumptions made for variables where less specific literature data available; wide range set for sensitivity analyses.

  • c Children placed in protective setting carry general population risk of iTBI; children placed in nonprotective setting (1-p) carry same risk of repeat iTBI as children with missed iTBI.

  • d Weekly probability reflects 30% (26%-45%) risk of repeat iTBI over 47 model weeks.

  • e All model costs adjusted to 2005 dollars.

  • f Comprehensive outpatient child abuse consultation and 2 skeletal surveys.

  • g First quartile estimate for children hospitalized with iTBI, ranged from minimum to median costs.

  • h Median estimate for children hospitalized with iTBI, ranged from first to third quartile costs.

  • i Third quartile estimate for children hospitalized with iTBI, ranged from median to maximum costs.

  • j Median estimate for children hospitalized with iTBI, ranged from minimum to maximum costs.

  • k Median to mean of Medicaid reimbursements for all children .

  • l Median to mean of Medicaid reimbursements for all children with cerebral palsy.