View : 46 Download: 0

lCost-effectiveness of coronary CT angiography in patients with chest pain: Comparison with myocardial single photon emission tomography

Title
lCost-effectiveness of coronary CT angiography in patients with chest pain: Comparison with myocardial single photon emission tomography
Authors
Lee, Seung-PyoJang, Eun JinKim, Yong-JinCha, Myung-JinPark, Sun-YoungSong, Hyun JinChoi, Ji EunShim, Jung-ImAhn, JeonghoonLee, Hyun Joo
Ewha Authors
안정훈
SCOPUS Author ID
안정훈scopus
Issue Date
2015
Journal Title
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
ISSN
1934-5925JCR Link
Citation
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY vol. 9, no. 5, pp. 428 - 437
Keywords
Coronary artery diseaseCoronary computed tomography angiographyCost-effectivenessMyocardial single photon emission computed tomography
Publisher
ELSEVIER SCIENCE INC
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Background: Coronary CT angiography (CCTA) has been proven accurate and is incorporated in clinical recommendations for coronary artery disease (CAD) diagnosis workup, but costeffectiveness data, especially in comparison to other methods such as myocardial single photon emission CT (SPECT) are insufficient. Objective: To compare the cost-effectiveness of CCTA and myocardial SPECT in a real-world setting. Methods: We performed a retrospective cohort study on consecutive patients with suspected CAD and a pretest probabili between 10% and 90%. Test accuracy was compared by correcting referral bias to coronary angiography depending on noninvasive' test results based on the Bayes' theorem and also by incorporating 1-year follow-up results. Costeffectiveness was analyzed using test accuracy and quality-adjusted life year (QALY). The model using diagnostic accuracy used the number of patients accurately diagnosed among 1000 persons as the effect and contained only expenses for diagnostic testing as the cost. In the model using QALY, a decision tree was developed, and the time horizon was 1 year. Results: CCTA was performed in 635 patients and SPECT in 997 patients. An accurate diagnosis per 1000 patients was achieved in 725 patients by CCTA vs 661 patients by SPECT. In the model using diagnostic accuracy, CCTA was more effective and less expensive than SPECT ($725.38 for CCTA vs $661.46 for SPECT). In the model using QALY, CCTA was generally more effective in terms of life quality (0.00221 QALY) and cost ($513) than SPECT. However, cost utility varied among subgroups, with SPECT outperforming CCTA in patients with a pretest probability of 30% to 60% (0.01890 QALY; $113). Conclusion: These results suggest that CCTA may be more cost-effective than myocardial SPECT. (C) 2015 Society of Cardiovascular Computed Tomography. All rights reserved.
DOI
10.1016/j.jcct.2015.02.008
Appears in Collections:
신산업융합대학 > 융합보건학과 > Journal papers
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE