SynthesisHeart (British Cardiac Society)2007
Is primary angioplasty cost effective in the UK? Results of a comprehensive decision analysis.
Synthesis in Heart (British Cardiac Society), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Assessing the effectiveness of primary angioplasty compared with thrombolysis and its relationship to time delay: a Bayesian evidence synthesis.Heart (British Cardiac Society) · 2007Pooled it
- Clinical evaluation of magnetic resonance imaging in coronary heart disease: the CE-MARC study.Trials · 2009Trial
- Long-Term Cost-Effectiveness of Fractional Flow Reserve-Based Percutaneous Coronary Intervention in Stable and Unstable Angina.JACC. Advances · 2022Article
- Cost-utility of surgical sutureless bioprostheses vs TAVI in aortic valve replacement for patients at intermediate and high surgical risk.ClinicoEconomics and outcomes research : CEOR · 2018Article
- Long-term Cost-Effectiveness of Diagnostic Tests for Assessing Stable Chest Pain: Modeled Analysis of Anatomical and Functional Strategies.Clinical cardiology · 2016Article
- Cost-effectiveness of a European ST-segment elevation myocardial infarction network: results from the Catalan Codi Infart network.BMJ open · 2015Article
- Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention.World journal of cardiology · 2014Review
- Is primary angioplasty an acceptable alternative to thrombolysis? Quantitative and qualitative study of patient and carer satisfaction.Health expectations : an international journal of public participation in health care and health policy · 2010Article
- Percutaneous coronary revascularisation: is it ever worth what it costs?Heart (British Cardiac Society) · 2007Article
- Review
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the cost effectiveness of primary angioplasty, compared with medical management with thrombolytic drugs, to achieve reperfusion after acute myocardial infarction (AMI) from the perspective of the UK NHS.
designBayesian evidence synthesis and decision analytic model.
methodsA systematic review was conducted and Bayesian statistical methods used to synthesise evidence from 22 randomised control trials. Resource utilisation was based on UK registry data, published literature and national databases, with unit costs taken from routine NHS sources and published literature.
main outcome measureCosts from a health service perspective and outcomes measured as quality-adjusted life years (QALYs).
resultsFor the base case, the incremental cost-effectiveness ratio of primary angioplasty was 9241 pounds sterling for each additional QALY, with a probability of being cost effective of 0.90 for a cost-effectiveness threshold of 20,000 pounds sterling. Results were sensitive to variations in the additional time required to initiate treatment with primary angioplasty.
conclusionsPrimary angioplasty is cost effective for the treatment of AMI on the basis of threshold cost-effectiveness values used in the NHS and subject to a delay of up to about 80 minutes. These findings are mainly explained by the superior mortality benefit and the prevention of non-fatal outcomes associated with primary angioplasty for delays of up to this length.
Indexed as
Identifiers
What OpenQuestion holds
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.