Original ArticlesUsing a Cost-Benefit Analysis to Estimate Outcomes of a Clinical Treatment Guideline: Testing the Brain Trauma Foundation Guidelines for the Treatment of Severe Traumatic Brain InjuryFaul, Mark PhD; Wald, Marlena M. MLS, MPH; Rutland-Brown, Wesley MPH; Sullivent, Ernest E. MD; Sattin, Richard W. MDAuthor Information From the Division of Injury Response, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. Submitted for publication August 11, 2006. Accepted for publication May 29, 2007. Address for reprints: Mark Faul, PhD, Division of Injury Response, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717; email: [email protected]. The Journal of Trauma: Injury, Infection, and Critical Care: December 2007 - Volume 63 - Issue 6 - p 1271-1278 doi: 10.1097/TA.0b013e3181493080 Buy Metrics Abstract Background: A decade after promulgation of treatment guidelines by the Brain Trauma Foundation (BTF), few studies exist that examine the application of these guidelines for severe traumatic brain injury (TBI) patients. These studies have reported both cost savings and reduced mortality. Materials: We projected the results of previous studies of BTF guideline adoption to estimate the impact of widespread adoption across the United States. We used surveillance systems and national surveys to estimate the number of severely injured TBI patients and compared the lifetime costs of BTF adoption to the current state of treatment. Results: After examining the health outcomes and costs, we estimated that a substantial savings in annual medical costs ($262 million), annual rehabilitation costs ($43 million) and lifetime societal costs ($3.84 billion) would be achieved if treatment guidelines were used more routinely. Implementation costs were estimated to be $61 million. The net savings were primarily because of better health outcomes and a decreased burden on lifetime social support systems. We also estimate that mortality would be reduced by 3,607 lives if the guidelines were followed. Conclusions: Widespread adoption of the BTF guidelines for the treatment of severe TBI would result in substantial savings in costs and lives. The majority of cost savings are societal costs. Further validation work to identify the most effective aspects of the BTF guidelines is warranted. © 2007 Lippincott Williams & Wilkins, Inc.