Methodological design for economic evaluation in Public Access Defibrillation (PAD) trial

Area of Science:

• Cardiovascular research
• Public health interventions
• Health economics

Background:

• Lay responder use of automated external defibrillators (AEDs) is being evaluated for cost-effectiveness.
• A randomized trial compares CPR alone versus CPR with AED use by trained lay responders.
• The study focuses on individuals aged 50 years and older.

Purpose of the Study:

• To determine the economic value of lay responder AED use.
• To assess if AEDs improve survival outcomes at a reasonable cost.

Main Methods:

• Economic evaluation conducted alongside a randomized trial.
• Comparison of control (CPR) and intervention (CPR + AED) groups.
• Primary economic outcome: incremental cost-effectiveness ratio.

Main Results:

• 30 survivors in the intervention group vs. 15 in the control group (P = .03).
• Program and healthcare costs will be analyzed from a societal perspective.
• Incremental cost-effectiveness estimated using bootstrapping and decision analytic modeling.

Conclusions:

• The study will determine if lay responder defibrillation improves outcomes cost-effectively.
• Findings will inform resource allocation for acute cardiovascular event interventions.
• The methodology can serve as a framework for evaluating other cardiovascular interventions.