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A decision tree compares a base scenario using a second conventional ERCP with a proposed scenario adding cholangioscopy immediately after the first failed procedure. Outcomes use success rates, resource use and costs from literature or expert opinion within the Brazilian supplementary health sector. Results show higher success, fewer complications, and lower resource utilization, making the cholangioscopy approach cost-effective and dominant.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pd26-cost-effectiveness-of-endoscopic-retrograde-cholangiopancreatography-ercp-with-cholangioscopy-for-difficult-biliary-stones-after-failed-ercp-study-results-and-conclusions/445610/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pd26-cost-effectiveness-of-endoscopic-retrograde-cholangiopancreatography-ercp-with-cholangioscopy-for-difficult-biliary-stones-after-failed-ercp-study-results-and-conclusions/445610.png","ImageObject",300,407,{"name":92,"@type":93},"Noah","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What problem does the PD26 study address?","Question",{"text":113,"@type":114},"Patients with difficult biliary stones often need repeated conventional ERCPs or surgical interventions after treatment failure, increasing complications and costs.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was cost effectiveness assessed in PD26?",{"text":118,"@type":114},"The study used a decision tree model comparing a second conventional ERCP versus cholangioscopy used immediately after the first failed ERCP, using success rates, resources, and costs from literature or expert opinion.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the key findings and outcomes of PD26?",{"text":122,"@type":114},"ERCP with cholangioscopy right after a failed conventional ERCP was cost-effective and dominant, improving stone removal success and reducing resource use and complication rates.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},445610,1790804325,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":81,"preview_page_count":4},8796095462418,"https://ap-avatar.wpscdn.com/avatar/80000253c1241d02b47?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778826106357471780","Poster Presentations (online) S49  \nof people with AIS in Uruguay, 1.5 percent of them will have access to MT, for a base expected number of at least 3 percent according to real-world data.  \nConclusions: Access to MT financed by the FNR was lower than expected. To date, the number of patients that apply for financial coverage by the FNR remains stable at approximately 70 cases per year, with a significant disparity observed in geographical origin (Montevideo versus the interior) and in the patient’s healthcare provider of origin (public versus private) .  \nPD25 Identification Of Unmet Medical Needs Through A Health Technology Assessment Process To Guide Research And Development: Experience From A University Hospital  \nLaís Lopes ([lplopes@hcpa.edu.br](lplopes@hcpa.edu.br)), Fernanda Oliveira, Cintia Oliveira, Barbara Pacheco and  \nMaria Angélica Ferreira  \nIntroduction: During the health technology assessment (HTA) process it is possible to identify unmet medical needs (UMN) that can be used to guide research and development investments. This study aimed to develop a methodology to identify and prioritize research and development themes using UMN identification in the HTA process of a teaching hospital.  \nMethods: We reviewed and looked forUMN inall the HTA technical reports related to technology incorporation solicitations submitted between 2018 and 2023 . The UMN definition used was based on that published by the US Food and Drug Administration in 2014 . A prioritization process was adopted using criteria based on the World Health Organization and the Brazilian Unified Health System list of priorities for the year. The UMN were categorized by characteristics such as indication (diagnostic, therapeutic, preventive, rehabilitation) and type of diseases.  \nResults: Thirty-seven Structured Technical Reports—formal documents submitted for evaluation of health technologies—were reviewed by two investigators. Among these, 37 UMN were identified, most of which were characterized as therapeutic needs (59.5%) or related to neurological diseases (16.2%) . According to established criteria, 81.1 percent of the UMN warranted investment in research and technology development.  \nConclusions: The proposed methodology can reliably identify UMNby analyzing technical reports. Further improvements can make it possible to fit the process to diverse HTA systems to support research and development decisions and investments.  \nPD26 Cost Effectiveness Of Endoscopic Retrograde Cholangiopancreatography (ERCP) With Cholangioscopy For Difficult Biliary Stones After Failed ERCP: Brazilian Health Sector Perspective  \nHenrique Tortele, Maiara Antonio  \n( [maiara.antonio@bsci.com](maiara.antonio@bsci.com)), Anna Pereira and Murilo Contó  \nIntroduction: Patients with difficult biliary stones often require repeated conventional ERCP procedures or others surgical interventions, leading to complications and unnecessary expenses for the healthcare system. ERCP with cholangioscopy allows direct visualization and use of laser or electrohydraulic lithotripsy, which are not possible without cholangioscopy. This study aimed to evaluate the cost effectiveness of ERCP with cholangioscopy for treating difficult biliary stones.  \nMethods: A decision tree model was developed to estimate the cost effectiveness of ERCP with cholangioscopy for direct visualization. Patients started the model with difficult biliary stones after an initial failed ERCP procedure. In the base scenario, patients underwent a second conventional ERCP procedure. In the proposed scenario, cholangioscopy was used in the same procedure immediately after the first failed ERCP. In the case of technical success with complete removal of the stones, patients exited the model, otherwise surgery was performed. Estimates of success rate, resources used, and costs were obtained from the literature or expert opinion and estimated from the supplementary health sector’s perspective.  \nResults: ERCP with cholangio","cbCaihVRGMB9uvkH","https://ap.wps.com/l/cbCaihVRGMB9uvkH","pdf",33443,"English","# PD25 Identification Of Unmet Medical Needs Through A Health Technology Assessment Process To Guide Research And Development - Experience From A University Hospital\n## Introduction\n## Methods\n## Results\n## Conclusions\n# PD26 Cost Effectiveness Of Endoscopic Retrograde Cholangiopancreatography (ERCP) With Cholangioscopy For Difficult Biliary Stones After Failed ERCP - Brazilian Health Sector Perspective\n## Introduction\n## Methods\n## Results\n## Conclusions","[{\"question\":\"What problem does the PD26 study address?\",\"answer\":\"Patients with difficult biliary stones often need repeated conventional ERCPs or surgical interventions after treatment failure, increasing complications and costs.\"},{\"question\":\"How was cost effectiveness assessed in PD26?\",\"answer\":\"The study used a decision tree model comparing a second conventional ERCP versus cholangioscopy used immediately after the first failed ERCP, using success rates, resources, and costs from literature or expert opinion.\"},{\"question\":\"What were the key findings and outcomes of PD26?\",\"answer\":\"ERCP with cholangioscopy right after a failed conventional ERCP was cost-effective and dominant, improving stone removal success and reducing resource use and complication rates.\"}]","PD26 Cost Effectiveness Of Endoscopic Retrograde Cholangiopancreatography (ERCP) With Cholangioscopy For Difficult Biliary Stones After Failed ERCP - Study results and conclusions | PDF",1790712459]