Cost savings with a new screening algorithm for pulmonary arterial hypertension in systemic sclerosis

Internal Medicine Journal
A QuinlivanM Nikpour

Abstract

Screening for pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) is now standard care in this disease. The existing Australian Scleroderma Interest Group algorithm (ASIGSTANDARD ) is based on transthoracic echocardiography (TTE) and pulmonary function tests (PFT). Recently, ASIG has derived and validated a new screening algorithm (ASIGPROPOSED ) that incorporates N-terminal pro-B-type natriuretic peptide level together with PFT in order to decrease reliance on TTE, which has some limitations. Right heart catheterisation (RHC) remains the gold standard for the diagnosis of PAH in patients who screen 'positive'. To compare the cost of PAH screening in SSc with ASIGSTANDARD and ASIGPROPOSED algorithms. We applied both ASIGSTANDARD and ASIGPROPOSED algorithms to 643 screen-naïve SSc patients from the Australian Scleroderma Cohort Study (ASCS), assuming a PAH prevalence of 10%. We compared the costs of screening, the number of TTE required and both the total number of RHC required and the number of RHC needed to diagnose one case of PAH, and costs, according to each algorithm. We then extrapolated the costs to the estimated total Australian SSc population. In screen-naïve patients from the ASCS, ASIGPROPOSED resulted ...Continue Reading

References

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Citations

Aug 2, 2019·European Respiratory Review : an Official Journal of the European Respiratory Society·Jason WeatheraldMarc Humbert
Dec 21, 2019·European Heart Journal Supplements : Journal of the European Society of Cardiology·David G KielyMarc Humbert
Mar 24, 2017·Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists·Tresa M Roebuck-SpencerKevin J Bianchini
Jun 4, 2016·Internal Medicine Journal·M NikpourW Stevens
Sep 30, 2016·BMC Pulmonary Medicine·Kathleen MorrisroeUNKNOWN Australian Scleroderma Interest Group (ASIG)
Nov 14, 2015·Internal Medicine Journal·L A Simmons
Jun 12, 2019·Internal Medicine Journal·Alannah QuinlivanUNKNOWN Australian Scleroderma Interest Group (ASIG)
Oct 28, 2017·International Journal of Rheumatic Diseases·Kathleen MorrisroeMandana Nikpour
Apr 5, 2020·Seminars in Arthritis and Rheumatism·T SemaluluM Hudson

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