Cost-effectiveness of stress echocardiography for assessment of coronary artery disease: what we know and what we need to know

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
T H Marwick

Abstract

This review explores the balance between the incremental data supplied by stress echocardiography and its cost. This technique is now established as an accurate tool for the diagnosis of coronary artery disease and myocardial viability, but the current medical-economic environment mandates careful consideration of the impact of the results on patient outcomes. The tools for assessment of cost and efficiency are reviewed. Two considerations are explored for controlling costs; avoidance of testing in those who will derive limited incremental data, and appropriate selection of stress echocardiography rather than other stress techniques. The balance between diagnostic accuracy and cost is explored in observational studies and computer models. Finally, the prognostic implications of testing are evaluated and data from the stress testing literature are explored to show that more effective patient selection for interventions may justify greater expenditure on testing. The appropriate selection of patients for testing has a significant evidence base. The cost of identifying coronary disease has been examined in a number of studies and facilitates the selection between testing modalities. Prognostic data are increasingly available, and ...Continue Reading

Citations

Jun 27, 2008·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Rosa SicariUNKNOWN European Association of Echocardiography
Jan 14, 2010·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Nicolai WennikeKim Greaves

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