压力心声学和运动耐受性测试的成本效益,作为在开始体育活动之前对无症状成年人进行查
Morris Mosseri1, Jacob Glazer2, Elinor Mosseri Briskin3
1Tel-Aviv University, Faculty of Medicine, Israel.
Computers in biology and medicine
|April 15, 2025
概括
应激心声学 (SE) 对于查无症状患者冠状动脉疾病 (CAD) 是具有成本效益的,当仅使用最佳医疗治疗时. 然而,如果考虑重新血管化的程序,它不是具有成本效益的.
科学领域:
- 心脏病学 心脏病学
- 卫生经济学 卫生经济学
- 预防医学 预防医学
背景情况:
- 之前对无症状个体的运动耐受性查由于特异性低,缺乏成本效益.
- 冠状动脉疾病 (CAD) 的诊断和治疗方面的进展需要重新评估查策略.
研究的目的:
- 确定压力心声学 (SE) 的成本效益,作为在开始体育活动之前对无症状个体的查工具.
主要方法:
- 一个决策树模型,比较SE查与无症状个体没有查.
- 使用5年马尔科夫模型和蒙特卡洛模拟 (1000次代) 来从保险公司的角度进行成本效益分析.
- 来自以色列卫生部的概率,医疗文献中的实用程序和治疗费用的数据.
主要成果:
- 当再血管化 (透管或绕道手术) 是一种选择时,SE 不具有成本效益,No-SE 组显示出更好的结果和更低的成本.
- 当仅进行最佳医疗治疗 (OMT) 时,SE占主导地位,产生更高的效益和成本节省 (ICER为27,644美元).
- 没有SE的运动耐受性测试 (ETT) 也显示了改善的效用,但当OMT是唯一的治疗时,它的效果比SE要低,ICER为1804美元.
结论:
- 对于无症状的个体,SE查是具有成本效益的,未经再血管化进行OMT,符合当前的指导方针.
- 在只有OMT的场景中,SE提高了患者的效用,并带来了财务节省.
- 当SE无法使用时,ETT是SE的一个有价值的替代品,因为其有利的ICER低于支付意愿值.
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