Evidence map›Paper›PMID 16756680›Full record

ArticleBMC health services research2006

Using the net benefit regression framework to construct cost-effectiveness acceptability curves: an example using data from a trial of external loop recorders versus Holter monitoring for ambulatory monitoring of "community acquired" syncope.

Jeffrey S Hoch, Marie Antoinette Rockx, Andrew D Krahn

2 registry-linked trialsOpen access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 94 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
94citing papers in PubMed, 2 pooled it
3.6field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02043080 nacompletednot on this mapstarted 2012, after this paper: background citation

CIDRZ 1201 - Optimizing Clinical Outcomes in HIV-Infected Adults & Children Using Xpert MTB/RIF in Zambia

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2012 to 2017Enrolled1,436ConditionsTuberculosis Diagnosis, HIVArmsXpert MTB/RIF Tuberculosis diagnostic tool
NCT02877420 nacompletednot on this mapstarted 2015, after this paper: background citation

Impact of a Simulation-based Training Curriculum of Non-technical Skills on Colonoscopy Performance

TypeinterventionalSponsorUnity Health TorontoRan2015 to 2016Enrolled42ConditionsEndoscopy SimulationArmsNon-Technical Skills Training Curriculum, Conventional Simulation Training Group
3 · Its place in the literature

Who cites it

94 citing papers in PubMed, 2 syntheses or guidelines pooled it, 169 citations in OpenAlex.

  1. Pooled it
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  3. Cost-Effectiveness of Remote Cognitive-Behavioral-Based Therapy for Chronic Pain Among People With High-Impact Chronic Pain.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2026
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34 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Jeffrey S HochCentre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada. jeffrey.hoch@utoronto.ca
Marie Antoinette Rockx
Andrew D Krahn
Western University · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCost-effectiveness acceptability curves (CEACs) describe the probability that a new treatment or intervention is cost-effective. The net benefit regression framework (NBRF) allows cost-effectiveness analysis to be done in a simple regression framework. The objective of the paper is to illustrate how net benefit regression can be used to construct a CEAC.

methodsOne hundred patients referred for ambulatory monitoring with syncope or presyncope were randomized to a one-month external loop recorder (n = 49) or 48-hour Holter monitor (n = 51). The primary endpoint was symptom-rhythm correlation during monitoring. Direct costs were calculated based on the 2003 Ontario Health Insurance Plan (OHIP) fee schedule combined with hospital case costing of labour, materials, service and overhead costs for diagnostic testing and related equipment.

resultsIn the loop recorder group, 63.27% of patients (31/49) had symptom recurrence and successful activation, compared to 23.53% in the Holter group (12/51). The cost in US dollars for loop recording was 648.50 dollars and 212.92 dollars for Holter monitoring. The incremental cost-effectiveness ratio (ICER) of the loop recorder was 1,096 dollars per extra successful diagnosis. The probability that the loop recorder was cost-effective compared to the Holter monitor was estimated using net benefit regression and plotted on a CEAC. In a sensitivity analysis, bootstrapping was used to examine the effect of distributional assumptions.

conclusionThe NBRF is straightforward to use and interpret. The resulting uncertainty surrounding the regression coefficient relates to the CEAC. When the link from the regression's p-value to the probability of cost-effectiveness is tentative, bootstrapping may be used.

Indexed as

Bayes TheoremCost-Benefit AnalysisElectrocardiography, AmbulatoryFee SchedulesHospital CostsHumansNational Health ProgramsOntarioProspective StudiesRecurrenceRegression AnalysisSyncopeTape Recording

Identifiers

PMID16756680
PMCPMC1543623
OpenAlexW1937705451

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.