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

被引：13

作者：

Pandya, Ankur ^{[1
]}

Yu, Yuan-Jui ^{[2
]}

Ge, Yin ^{[3
]}

Nagel, Eike ^{[4
]}

Kwong, Raymond Y. ^{[3
]}

Abu Bakar, Rafidah ^{[5
]}

Grizzard, John D. ^{[6
]}

Merkler, Alexander E. ^{[7
]}

Ntusi, Ntobeko ^{[8
]}

Petersen, Steffen E. ^{[9
]}

Rashedi, Nina ^{[10
]}

Schwitter, Juerg ^{[11
,12
]}

Selvanayagam, Joseph B. ^{[13
,14
]}

White, James A. ^{[15
]}

Carr, James ^{[16
]}

Raman, Subha V. ^{[17
]}

Simonetti, Orlando P. ^{[18
,19
]}

Bucciarelli-Ducci, Chiara ^{[20
,21
]}

Sierra-Galan, Lilia M. ^{[22
]}

Ferrari, Victor A. ^{[23
,24
]}

Bhatia, Mona ^{[25
]}

Kelle, Sebastian ^{[26
,27
]}

机构：

[1] Harvard TH Chan Sch Publ Hlth, Dept Hlth Policy & Management, 718 Huntington Ave,2nd Floor, Boston, MA 02115 USA

[2] Natl Taiwan Univ Hosp, Taipei, Taiwan

[3] Brigham & Womens Hosp, Cardiovasc Div Dept Med, 75 Francis St, Boston, MA 02115 USA

[4] Univ Hosp Frankfurt, Inst Expt & Translat Cardiovasc Imaging, DZHK German Centre Cardiovasc Res, Ctr Cardiovasc Imaging, Frankfurt, Germany

[5] Natl Heart Inst, Dept Cardiol, Kuala Lumpur, Malaysia

[6] Virginia Commonwealth Univ Med Ctr, Main Hosp, Dept Radiol, Richmond, VA USA

[7] Presbyterian Hosp, Dept Neurol, Weill Cornell Med, NewYork, New York, NY USA

[8] Univ Cape Town, Groote Schuur Hosp, Dept Med, Cape Town, South Africa

[9] Queen Mary Univ London, William Harvey Res Inst, NIHR Barts BioMed Res Centre, London, England

[10] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA

[11] CMR Ctr Univ Hosp, Cardiovasc Dept, Div Cardiol, Lausanne, Switzerland

[12] Univ Lausanne, Fac Biol & Med, UniL, Lausanne, Switzerland

[13] Flinders Univ S Australia, Sch Med & Publ Hlth, Dept Med, Adelaide, Australia

[14] South Australian Hlth & Med Res Inst, Dept Heart Hlth, Adelaide, Australia

[15] Univ Calgary, Stephenson Cardiac Imaging Ctr, Dept Cardiac Sci, Div Cardiol, Calgary, AB, Canada

[16] Northwestern Univ, Feinberg Sch Med, Dept Radiol, Chicago, IL USA

[17] Indiana Univ, Krannert Inst Cardiol, Sch Med, Indianapolis, IN USA

[18] Ohio State Univ, Dept Internal Med, Columbus, OH 43210 USA

[19] Ohio State Univ, Dept Radiol, Columbus, OH 43210 USA

[20] Univ Hosp Bristol NHS Trust, NIHR Biomed Res Ctr, Bristol Natl Inst Hlth Res, Bristol Heart Inst, Bristol, Avon, England

[21] Univ Bristol, Bristol, Avon, England

[22] Amer British Cowdray Med Ctr, Dept Cardiol, Cardiovasc Div, Mexico City, DF, Mexico

[23] Univ Penn, Med Ctr, Perelman Sch Med, Cardiovasc Div, Philadelphia, PA USA

[24] Univ Penn, Med Ctr, Penn Cardiovasc Inst, Philadelphia, PA USA

[25] Fortis Escorts Heart Inst, Dept Imaging, New Delhi, India

[26] Charite Univ med Berlin, Dept Internal Med & Cardiol, Campus Virchow Klinikum, Berlin, Germany

[27] German Heart Inst Berlin DHZB, Partner Site Berlin, DZHK German Ctr Cardiovasc Res, Dept Internal Med & Cardiol, Berlin, Germany

来源：

JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE | 2022年 / 24卷 / 01期

关键词：

Cost-effectiveness; Cardiovascular magnetic resonance; Coronary artery disease; STABLE CHEST-PAIN; EMISSION COMPUTED-TOMOGRAPHY; DIAGNOSTIC PERFORMANCE; HEART-DISEASE; STRESS CMR; HEALTH; ANGIOGRAPHY; STATEMENT; TESTS;

D O I：

10.1186/s12968-021-00833-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Although prior reports have evaluated the clinical and cost impacts of cardiovascular magnetic resonance (CMR) for low-to-intermediate-risk patients with suspected significant coronary artery disease (CAD), the cost-effectiveness of CMR compared to relevant comparators remains poorly understood. We aimed to summarize the cost-effectiveness literature on CMR for CAD and create a cost-effectiveness calculator, useable worldwide, to approximate the cost-per-quality-adjusted-life-year (QALY) of CMR and relevant comparators with context-specific patient-level and system-level inputs. Methods We searched the Tufts Cost-Effectiveness Analysis Registry and PubMed for cost-per-QALY or cost-per-life-year-saved studies of CMR to detect significant CAD. We also developed a linear regression meta-model (CMR Cost-Effectiveness Calculator) based on a larger CMR cost-effectiveness simulation model that can approximate CMR lifetime discount cost, QALY, and cost effectiveness compared to relevant comparators [such as single-photon emission computed tomography (SPECT), coronary computed tomography angiography (CCTA)] or invasive coronary angiography. Results CMR was cost-effective for evaluation of significant CAD (either health-improving and cost saving or having a cost-per-QALY or cost-per-life-year result lower than the cost-effectiveness threshold) versus its relevant comparator in 10 out of 15 studies, with 3 studies reporting uncertain cost effectiveness, and 2 studies showing CCTA was optimal. Our cost-effectiveness calculator showed that CCTA was not cost-effective in the US compared to CMR when the most recent publications on imaging performance were included in the model. Conclusions Based on current world-wide evidence in the literature, CMR usually represents a cost-effective option compared to relevant comparators to assess for significant CAD.

引用

页数：14

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