Cost-effectiveness of stress CTP versus CTA in detecting obstructive CAD or in-stent restenosis in stented patients.
Saved in:
| Title: | Cost-effectiveness of stress CTP versus CTA in detecting obstructive CAD or in-stent restenosis in stented patients. |
|---|---|
| Authors: | Kim, S. H.1 (AUTHOR), Rübenthaler, J.1 (AUTHOR), Nörenberg, D.2 (AUTHOR), Huber, T.2 (AUTHOR), Kunz, W. G.1 (AUTHOR), Sommer, W. H.1 (AUTHOR), Schoenberg, S. O.2 (AUTHOR), Janssen, S.2 (AUTHOR), Overhoff, D.2 (AUTHOR), Froelich, M. F.2 (AUTHOR) matthias.froelich@medma.uni-heidelberg.de |
| Source: | European Radiology. Mar2021, Vol. 31 Issue 3, p1443-1450. 8p. 1 Diagram, 1 Chart, 2 Graphs. |
| Subjects: | Cost effectiveness, Quality-adjusted life years, Coronary angiography, Markov processes, Willingness to pay |
| Abstract: | Objectives: The aim of this retrospective study was to determine cost-effectiveness of stress myocardial CT perfusion (CTP), coronary CT angiography (CTA), and the combination of both in suspected obstructive coronary artery disease (CAD) or in-stent restenosis (ISR) in patients with previous coronary stent implantation. Methods: A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with CTA, CTP, and CTA + CTP. Model input parameters were obtained from published literature. Probabilistic sensitivity analysis was performed to evaluate overall model uncertainty. A single-variable deterministic sensitivity analysis evaluated the sensitivity of the results to plausible variations in model inputs. Cost-effectiveness was assessed based on a cost-effectiveness threshold of $100,000 per QALY. Results: In the base-case scenario with willingness to pay of $100,000 per QALY, CTA resulted in total costs of $47,013.87 and an expected effectiveness of 6.84 QALYs, whereas CTP resulted in total costs of $46,758.83 with 6.93 QALYs. CTA + CTP reached costs of $47,455.63 with 6.85 QALYs. Therefore, strategies CTA and CTA + CTP were dominated by CTP in the base-case scenario. Deterministic sensitivity analysis demonstrated robustness of the model to variations of diagnostic efficacy parameters and costs in a broad range. CTP was cost-effective in the majority of iterations in the probabilistic sensitivity analysis as compared with CTA. Conclusions: CTP is cost-effective for the detection of obstructive CAD or ISR in patients with previous stenting and therefore should be considered a feasible approach in daily clinical practice. Key Points: • CTP provides added diagnostic value in patients with previous coronary stents. • CTP is a cost-effective method for the detection of obstructive CAD or ISR in patients with previous stenting. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
|
Full text is not displayed to guests.
Login for full access.
|
|
| FullText | Links: – Type: pdflink Text: Availability: 1 |
|---|---|
| Header | DbId: egs DbLabel: Engineering Source An: 148678349 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Cost-effectiveness of stress CTP versus CTA in detecting obstructive CAD or in-stent restenosis in stented patients. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Kim%2C+S%2E+H%2E%22">Kim, S. H.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rübenthaler%2C+J%2E%22">Rübenthaler, J.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nörenberg%2C+D%2E%22">Nörenberg, D.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Huber%2C+T%2E%22">Huber, T.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kunz%2C+W%2E+G%2E%22">Kunz, W. G.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sommer%2C+W%2E+H%2E%22">Sommer, W. H.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schoenberg%2C+S%2E+O%2E%22">Schoenberg, S. O.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Janssen%2C+S%2E%22">Janssen, S.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Overhoff%2C+D%2E%22">Overhoff, D.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Froelich%2C+M%2E+F%2E%22">Froelich, M. F.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<i> matthias.froelich@medma.uni-heidelberg.de</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Mar2021, Vol. 31 Issue 3, p1443-1450. 8p. 1 Diagram, 1 Chart, 2 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Cost+effectiveness%22">Cost effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Quality-adjusted+life+years%22">Quality-adjusted life years</searchLink><br /><searchLink fieldCode="DE" term="%22Coronary+angiography%22">Coronary angiography</searchLink><br /><searchLink fieldCode="DE" term="%22Markov+processes%22">Markov processes</searchLink><br /><searchLink fieldCode="DE" term="%22Willingness+to+pay%22">Willingness to pay</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: The aim of this retrospective study was to determine cost-effectiveness of stress myocardial CT perfusion (CTP), coronary CT angiography (CTA), and the combination of both in suspected obstructive coronary artery disease (CAD) or in-stent restenosis (ISR) in patients with previous coronary stent implantation. Methods: A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with CTA, CTP, and CTA + CTP. Model input parameters were obtained from published literature. Probabilistic sensitivity analysis was performed to evaluate overall model uncertainty. A single-variable deterministic sensitivity analysis evaluated the sensitivity of the results to plausible variations in model inputs. Cost-effectiveness was assessed based on a cost-effectiveness threshold of $100,000 per QALY. Results: In the base-case scenario with willingness to pay of $100,000 per QALY, CTA resulted in total costs of $47,013.87 and an expected effectiveness of 6.84 QALYs, whereas CTP resulted in total costs of $46,758.83 with 6.93 QALYs. CTA + CTP reached costs of $47,455.63 with 6.85 QALYs. Therefore, strategies CTA and CTA + CTP were dominated by CTP in the base-case scenario. Deterministic sensitivity analysis demonstrated robustness of the model to variations of diagnostic efficacy parameters and costs in a broad range. CTP was cost-effective in the majority of iterations in the probabilistic sensitivity analysis as compared with CTA. Conclusions: CTP is cost-effective for the detection of obstructive CAD or ISR in patients with previous stenting and therefore should be considered a feasible approach in daily clinical practice. Key Points: • CTP provides added diagnostic value in patients with previous coronary stents. • CTP is a cost-effective method for the detection of obstructive CAD or ISR in patients with previous stenting. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=148678349 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-020-07202-z Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 1443 Subjects: – SubjectFull: Cost effectiveness Type: general – SubjectFull: Quality-adjusted life years Type: general – SubjectFull: Coronary angiography Type: general – SubjectFull: Markov processes Type: general – SubjectFull: Willingness to pay Type: general Titles: – TitleFull: Cost-effectiveness of stress CTP versus CTA in detecting obstructive CAD or in-stent restenosis in stented patients. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Kim, S. H. – PersonEntity: Name: NameFull: Rübenthaler, J. – PersonEntity: Name: NameFull: Nörenberg, D. – PersonEntity: Name: NameFull: Huber, T. – PersonEntity: Name: NameFull: Kunz, W. G. – PersonEntity: Name: NameFull: Sommer, W. H. – PersonEntity: Name: NameFull: Schoenberg, S. O. – PersonEntity: Name: NameFull: Janssen, S. – PersonEntity: Name: NameFull: Overhoff, D. – PersonEntity: Name: NameFull: Froelich, M. F. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 03 Text: Mar2021 Type: published Y: 2021 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 31 – Type: issue Value: 3 Titles: – TitleFull: European Radiology Type: main |
| ResultId | 1 |
