Cost-effectiveness of functional cardiac imaging in the diagnostic work-up of coronary heart disease

European Heart Journal. Quality of Care & Clinical Outcomes
Mark PletscherFrançois R Girardin

Abstract

The aim of this study was to assess the cost-effectiveness of eight common diagnostic work-up strategies for coronary heart disease (CHD) in patients with stable angina symptoms in Switzerland. A decision analytical model was used to perform a cost-effectiveness comparison of eight common multitest strategies to diagnose CHD using combinations of four diagnostic techniques: exercise treadmill test (ETT), single-photon emission computed tomography (SPECT), cardiac magnetic resonance imaging (CMR), and coronary angiography (CA). We used a Markov state transition model to extrapolate the results over a life-time horizon, from a third-party payer perspective. We used a CHD prevalence rate of 39% in patients and a base-case scenario with 60-year-old male patients with intermediate symptom severity Canadian Cardiovascular Society grading of angina pectoris 2 and at least one cardiovascular (CV) risk factor but without a history of myocardial infarction and without need for revascularization. Among the eight work-up strategies, one strategy was dominant, i.e. least costly and most effective: ETT followed by CMR if the ETT result was inconclusive and then CA if the CMR result was positive or inconclusive. The CMR features a favourable ...Continue Reading

References

Feb 1, 1995·British Heart Journal·M M GandhiD A Wood
Aug 21, 2003·JAMA : the Journal of the American Medical Association·Umesh N KhotEric J Topol
Apr 15, 2004·European Journal of Public Health·Irmgard Schmitt-KoopmannThomas D Szucs
Dec 4, 2010·Circulation·William F FearonUNKNOWN Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) Study Investigators
Mar 23, 2011·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Patrick W SullivanVahram Ghushchyan
Jan 22, 2013·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Oliver BruderHeiko Mahrholdt
Jun 20, 2014·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Manuel A EspinozaMark J Sculpher
Mar 17, 2015·The New England Journal of Medicine·Pamela S DouglasUNKNOWN PROMISE Investigators
Jan 7, 2016·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Robin J TaylorFrancisco Leyva

❮ Previous
Next ❯

Citations

Apr 18, 2020·The British Journal of Radiology·Silanath Terpenning, Arthur Stillman
Dec 14, 2019·The British Journal of Radiology·Marly van AssenJuerg Schwitter
Sep 17, 2019·World Journal of Cardiology·Ioannis MerinopoulosVassilios S Vassiliou
Sep 25, 2020·La Radiologia medica·Maurizio CentonzeFrancesco De Cobelli

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.