Related Experiment Video
Updated: Jan 30, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Low-Intensity Monitoring for Mild-to-Moderate Acute Ischemic Stroke Is Cost Saving: Economic Evaluation for
Lizheng Xu1, Menglu Ouyang1, Emily R Atkins1
1The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (L.X., M.O., E.R.A., L.B., A. Malavera, P.M.-V., X.L., Q.L., L.S., C.D., H.L., X.W., S.J., C.S.A.).
Background:
OPTIMISTmain (Main Optimal Post rtPA-IV Monitoring in Ischemic Stroke Trial) has shown that low-intensity monitoring is feasible and safe compared with standard monitoring in stable patients who receive thrombolysis treatment for acute ischemic stroke of mild-to-moderate neurological impairment. We aimed to estimate the economic benefits of low-intensity care compared with standard care.
Methods:
A cost-minimization analysis based on OPTIMISTmain was conducted for Australia, China, Malaysia, the United Kingdom, the United States, and Vietnam. A decision tree model comprising 2 arms was developed from the trial design. State transition probabilities for each country were extracted from the trial, and cost data were sourced from the existing literature. Mean costs over the 90-day duration of follow-up were compared, and univariate and probabilistic sensitivity and scenario analyses were performed.
Results:
Low-intensity monitoring had the highest probability of cost saving in China (100.00%) and the United Kingdom (100.00%), followed by Australia (99.94%), the United States (95.91%), and Vietnam (86.66%), as patients in this group incurred US dollars savings of 239, 133, 647, 943, and 3 in direct costs compared with patients in the standard group, respectively. In Malaysia, however, the intervention costs slightly exceeded those for standard care (US dollars 5643 versus 5378). Countries with higher proportions of patients having intensive care unit monitoring had greater cost savings. Cost-saving thresholds of monitoring costs were 1.24, 1.30, 1.26, 1.24, 1.01, and 0.91 times the base case value in Australia, China, the United Kingdom, the United States, Vietnam, and Malaysia, respectively.
Conclusions:
The low-intensity monitoring protocol was cost saving in countries with high proportions of intensive care resources for postthrombolysis treatment monitoring, such as in the United States.
Registration:
URL: https://www.clinicaltrials.gov; Unique identifier: NCT03734640. URL: https://www.anzctr.org.au/; Unique identifier: ACTRN 12619001556134p.
More Related Videos
07:40Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training
Published on: October 10, 2019
07:34Author Spotlight: Establishing a Reliable Distal MCA Occlusion Model in Mice for Stroke Research
Published on: December 15, 2023
Related Concept Videos
00:58Sound Intensity
00:53Sound Intensity Level
The human ear can perceive an extensive range of sound intensity, necessitating the use of the logarithmic scale to define a physical quantity—the intensity level. It is a ratio of two intensities and...
01:22Intensity Of Electromagnetic Waves
01:05Intensity and Pressure of Sound Waves
Unlike the time average of a sinusoidal term, which is zero since it is positive...
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
00:55IR Spectrum Peak Intensity: Amount of IR-Active Bonds