Document Type

Article

Peer Reviewed

1

Publication Date

4-7-2016

NLM Title Abbreviation

Biomed Res Int

Journal/Book/Conference Title

BioMed Research International

PubMed ID

27243033

DOI of Published Version

10.1155/2016/6421039

Total Pages

9

Abstract

Whole exome sequencing (WES) has revolutionized the way we think about and diagnose epileptic encephalopathies. Multiple recent review articles discuss the benefits of WES and suggest various algorithms to follow for determining the etiology of epileptic encephalopathies. Incorporation of WES in these algorithms is leading to the discovery of new genetic diagnoses of early onset epileptic encephalopathies (EOEEs) at a rapid rate; however, WES is not yet a universally utilized diagnostic tool. Clinical WES may be underutilized due to provider discomfort in ordering the test or perceived costliness. At our hospital WES is not routinely performed for patients with EOEE due to limited insurance reimbursement. In fact for any patient with noncommercial insurance (Medicaid) the institution does not allow sending out WES as this is not "established"/"proven to be highly useful and cost effective"/"approved test" in patients with epilepsy. Recently, we performed WES on four patients from three families and identified novel mutations in known epilepsy genes in all four cases. These patients had State Medicaid as their insurance carrier and were followed up for several years for EOEE while being worked up using the traditional/approved testing methods. Following a recently proposed diagnostic pathway, we analyzed the cost savings (US dollars) that could be accrued if WES was performed earlier in the diagnostic odyssey. This is the first publication that addresses the dollar cost of traditional testing in EOEE as performed in these four cases versus WES and the potential cost savings.

Keywords

OAfund

Journal Article Version

Version of Record

Published Article/Book Citation

BioMed Research International. Volume 2016, Article ID 6421039, 8 pages http://dx.doi.org/10.1155/2016/6421039

Rights

Copyright © 2016 Charuta Joshi et al.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

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URL

http://ir.uiowa.edu/pediatrics_pubs/3