Literature DB >> 32817271

Cost-effectiveness of cardiovascular imaging for stable coronary heart disease.

Simon Walker1, Edward Cox2, Ben Rothwell3, Colin Berry4, Gerry P McCann5,6, Chiara Bucciarelli-Ducci7, Erica Dall'Armellina8,9, Abhiram Prasad10,11, James Robert John Foley8, Kenneth Mangion4, Petra Bijsterveld12, Colin Everett12, Deborah Stocken12, Sven Plein8, John P Greenwood8, Mark Sculpher2.   

Abstract

OBJECTIVE: To assess the cost-effectiveness of management strategies for patients presenting with chest pain and suspected coronary heart disease (CHD): (1) cardiovascular magnetic resonance (CMR); (2) myocardial perfusion scintigraphy (MPS); and (3) UK National Institute for Health and Care Excellence (NICE) guideline-guided care.
METHODS: Using UK data for 1202 patients from the Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease 2 trial, we conducted an economic evaluation to assess the cost-effectiveness of CMR, MPS and NICE guidelines. Health outcomes were expressed as quality-adjusted life-years (QALYs), and costs reflected UK pound sterling in 2016-2017. Cost-effectiveness results were presented as incremental cost-effectiveness ratios and incremental net health benefits overall and for low, medium and high pretest likelihood of CHD subgroups.
RESULTS: CMR had the highest estimated QALY gain overall (2.21 (95% credible interval 2.15, 2.26) compared with 2.07 (1.92, 2.20) for NICE and 2.11 (2.01, 2.22) for MPS) and incurred comparable costs (overall £1625 (£1431, £1824) compared with £1753 (£1473, £2032) for NICE and £1768 (£1572, £1989) for MPS). Overall, CMR was the cost-effective strategy, being the dominant strategy (more effective, less costly) with incremental net health benefits per patient of 0.146 QALYs (-0.18, 0.406) compared with NICE guidelines at a cost-effectiveness threshold of £15 000 per QALY (93% probability of cost-effectiveness). Results were similar in the pretest likelihood subgroups.
CONCLUSIONS: CMR-guided care is cost-effective overall and across all pretest likelihood subgroups, compared with MPS and NICE guidelines. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

Entities:  

Keywords:  cardiac imaging and diagnostics; cardiac magnetic resonance (CMR) imaging; health care economics

Mesh:

Year:  2020        PMID: 32817271      PMCID: PMC7892375          DOI: 10.1136/heartjnl-2020-316990

Source DB:  PubMed          Journal:  Heart        ISSN: 1355-6037            Impact factor:   5.994


  17 in total

1.  Estimating mean QALYs in trial-based cost-effectiveness analysis: the importance of controlling for baseline utility.

Authors:  Andrea Manca; Neil Hawkins; Mark J Sculpher
Journal:  Health Econ       Date:  2005-05       Impact factor: 3.046

2.  Multiple regression of cost data: use of generalised linear models.

Authors:  Julie Barber; Simon Thompson
Journal:  J Health Serv Res Policy       Date:  2004-10

3.  The optimal imaging strategy for patients with stable chest pain: a cost-effectiveness analysis.

Authors:  Tessa S S Genders; Steffen E Petersen; Francesca Pugliese; Amardeep G Dastidar; Kirsten E Fleischmann; Koen Nieman; M G Myriam Hunink
Journal:  Ann Intern Med       Date:  2015-04-07       Impact factor: 25.391

4.  Low diagnostic yield of elective coronary angiography.

Authors:  Manesh R Patel; Eric D Peterson; David Dai; J Matthew Brennan; Rita F Redberg; H Vernon Anderson; Ralph G Brindis; Pamela S Douglas
Journal:  N Engl J Med       Date:  2010-03-11       Impact factor: 91.245

5.  Initial Invasive or Conservative Strategy for Stable Coronary Disease.

Authors:  David J Maron; Judith S Hochman; Harmony R Reynolds; Sripal Bangalore; Sean M O'Brien; William E Boden; Bernard R Chaitman; Roxy Senior; Jose López-Sendón; Karen P Alexander; Renato D Lopes; Leslee J Shaw; Jeffrey S Berger; Jonathan D Newman; Mandeep S Sidhu; Shaun G Goodman; Witold Ruzyllo; Gilbert Gosselin; Aldo P Maggioni; Harvey D White; Balram Bhargava; James K Min; G B John Mancini; Daniel S Berman; Michael H Picard; Raymond Y Kwong; Ziad A Ali; Daniel B Mark; John A Spertus; Mangalath N Krishnan; Ahmed Elghamaz; Nagaraja Moorthy; Whady A Hueb; Marcin Demkow; Kreton Mavromatis; Olga Bockeria; Jesus Peteiro; Todd D Miller; Hanna Szwed; Rolf Doerr; Matyas Keltai; Joseph B Selvanayagam; P Gabriel Steg; Claes Held; Shun Kohsaka; Stavroula Mavromichalis; Ruth Kirby; Neal O Jeffries; Frank E Harrell; Frank W Rockhold; Samuel Broderick; T Bruce Ferguson; David O Williams; Robert A Harrington; Gregg W Stone; Yves Rosenberg
Journal:  N Engl J Med       Date:  2020-03-30       Impact factor: 91.245

6.  Prognostic Value of Cardiovascular Magnetic Resonance and Single-Photon Emission Computed Tomography in Suspected Coronary Heart Disease: Long-Term Follow-up of a Prospective, Diagnostic Accuracy Cohort Study.

Authors:  John P Greenwood; Bernhard A Herzog; Julia M Brown; Colin C Everett; Jane Nixon; Petra Bijsterveld; Neil Maredia; Manish Motwani; Catherine J Dickinson; Stephen G Ball; Sven Plein
Journal:  Ann Intern Med       Date:  2016-05-10       Impact factor: 25.391

7.  Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L).

Authors:  M Herdman; C Gudex; A Lloyd; Mf Janssen; P Kind; D Parkin; G Bonsel; X Badia
Journal:  Qual Life Res       Date:  2011-04-09       Impact factor: 4.147

8.  Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial.

Authors:  Michelle C Williams; Amanda Hunter; Anoop Shah; Valentina Assi; Stephanie Lewis; Kenneth Mangion; Colin Berry; Nicholas A Boon; Elizabeth Clark; Marcus Flather; John Forbes; Scott McLean; Giles Roditi; Edwin Jr van Beek; Adam D Timmis; David E Newby
Journal:  Heart       Date:  2017-02-28       Impact factor: 5.994

Review 9.  Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials.

Authors:  George Cm Siontis; Dimitris Mavridis; John P Greenwood; Bernadette Coles; Adriani Nikolakopoulou; Peter Jüni; Georgia Salanti; Stephan Windecker
Journal:  BMJ       Date:  2018-02-21

10.  Rationale and design of the Clinical Evaluation of Magnetic Resonance Imaging in Coronary heart disease 2 trial (CE-MARC 2): a prospective, multicenter, randomized trial of diagnostic strategies in suspected coronary heart disease.

Authors:  David P Ripley; Julia M Brown; Colin C Everett; Petra Bijsterveld; Simon Walker; Mark Sculpher; Gerry P McCann; Colin Berry; Sven Plein; John P Greenwood
Journal:  Am Heart J       Date:  2014-10-22       Impact factor: 4.749

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  5 in total

1.  Evidence-based cardiovascular magnetic resonance cost-effectiveness calculator for the detection of significant coronary artery disease.

Authors:  Ankur Pandya; Yuan-Jui Yu; Yin Ge; Eike Nagel; Raymond Y Kwong; Rafidah Abu Bakar; John D Grizzard; Alexander E Merkler; Ntobeko Ntusi; Steffen E Petersen; Nina Rashedi; Juerg Schwitter; Joseph B Selvanayagam; James A White; James Carr; Subha V Raman; Orlando P Simonetti; Chiara Bucciarelli-Ducci; Lilia M Sierra-Galan; Victor A Ferrari; Mona Bhatia; Sebastian Kelle
Journal:  J Cardiovasc Magn Reson       Date:  2022-01-06       Impact factor: 6.903

2.  Cost-effectiveness in diagnosis of stable angina patients: a decision-analytical modelling approach.

Authors:  Muhummad Sohaib Nazir; Yael Rodriguez-Guadarrama; Tiago Rua; Khan Ha Bui; Anna Buylova Gola; Amedeo Chiribiri; Paul McCrone; Sven Plein; Mark Pennington
Journal:  Open Heart       Date:  2022-04

3.  Intracoronary Ultrasound Imaging Combined with Traditional Chinese Medicine Nursing Applied in the Treatment of Coronary Heart Disease Patients with Phlegm and Blood Stasis Syndrome.

Authors:  Hui Zeng; Chunmian Guo; Yan Yang; Xia Chu; Yanru Shi
Journal:  Contrast Media Mol Imaging       Date:  2022-08-21       Impact factor: 3.009

4.  Regional variation in cardiovascular magnetic resonance service delivery across the UK.

Authors:  Niall G Keenan; Gabriella Captur; Gerry P McCann; Colin Berry; Saul G Myerson; Timothy Fairbairn; Lucy Hudsmith; Declan P O'Regan; Mark Westwood; John P Greenwood
Journal:  Heart       Date:  2021-03-25       Impact factor: 5.994

Review 5.  What Is the Role of Assessing Ischemia to Optimize Therapy and Outcomes for Patients with Stable Angina and Non-obstructed Coronary Arteries?

Authors:  Colin Berry; Andrew J Morrow; Mario Marzilli; Carl J Pepine
Journal:  Cardiovasc Drugs Ther       Date:  2021-05-12       Impact factor: 3.947

  5 in total

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