Evidence map›Paper›PMID 18936502›Full record

Trial reportAnnals of internal medicine2008

Cost-effectiveness of nurse-led disease management for heart failure in an ethnically diverse urban community.

Paul L Hebert, Jane E Sisk, Jason J Wang, Leah Tuzzio, Jodi M Casabianca, Mark R Chassin, Carol Horowitz, Mary Ann McLaughlin

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 10 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  6. Disease management interventions for heart failure.The Cochrane database of systematic reviews · 2019
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  9. Guideline
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  11. Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration.The European journal of health economics : HEPAC : health economics in prevention and care · 2019
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  20. Physician and informal care use explained by the Pediatric Quality of Life Inventory (PedsQL) in children with suspected genetic disorders.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Paul L HebertHealth Services Research and Development, Veterans Affairs Puget Sound Health CareSystem, 1100 Olive Way, Suite 1400, Seattle, WA 98101, USA.
Jane E Sisk
Jason J Wang
Leah Tuzzio
Jodi M Casabianca
Mark R Chassin
Carol Horowitz
Mary Ann McLaughlin

Funding

RESEARCH COREP60MD000270 · NIMHD · MOUNT SINAI SCHOOL OF MEDICINE OF NYU · PI HOROWITZ, CAROL R · 2002 to 2011
$15.1M
IMPROVING HEART FAILURE CARE IN MINORITY COMMUNITIESR01HS010402 · AHRQ · MOUNT SINAI SCHOOL OF MEDICINE OF NYU · PI SISK, JANE E · 1999 to 2001
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AHRQ HHS R01 HS010402AHRQ HHS R01 HS10402-01NIMHD NIH HHS P60 MD000270
6 · The paper itself

Abstract

backgroundRandomized, controlled trials have shown that nurse-led disease management for patients with heart failure can reduce hospitalizations. Less is known about the cost-effectiveness of these interventions.

objectiveTo estimate the cost-effectiveness of a nurse-led disease management intervention over 12 months, implemented in a randomized, controlled effectiveness trial.

designCost-effectiveness analysis conducted alongside a randomized trial. DATA SOURCES: Medical costs from administrative records, and self-reported quality of life and nonmedical costs from patient surveys.

participantsPatients with systolic dysfunction recruited from ambulatory clinics in Harlem, New York. TIME HORIZON: 12 months. PERSPECTIVE: Societal and payer.

intervention12-month program that involved 1 face-to-face encounter with a nurse and regular telephone follow-up. OUTCOME MEASURES: Quality of life as measured by the Health Utilities Index Mark 3 and EuroQol-5D and cost-effectiveness as measured by the incremental cost-effectiveness ratio (ICER). RESULTS OF BASE-CASE ANALYSIS: Costs and quality of life were higher in the nurse-managed group than the usual care group. The ICERs over 12 months were $17,543 per EuroQol-5D-based quality-adjusted life-year (QALY) and $15,169 per Health Utilities Index Mark 3-based QALY (in 2001 U.S. dollars). RESULTS OF SENSITIVITY ANALYSIS: From a payer perspective, the ICER ranged from $3673 to $4495 per QALY. Applying national prices in place of New York City prices yielded a societal ICER of $13,460 to $15,556 per QALY. Cost-effectiveness acceptability curves suggest that the intervention was most likely cost-effective for patients with less severe (New York Heart Association classes I to II) heart failure. LIMITATION: The trial was conducted in an ethnically diverse, inner-city neighborhood; thus, results may not be generalizable to other communities.

conclusionOver 12 months, the nurse-led disease management program was a reasonably cost-effective way to reduce the burden of heart failure in this community.

Indexed as

Disease ManagementNurse's RoleAdultAgedCost-Benefit AnalysisFemaleHeart FailureHospitalizationHumansMaleMiddle AgedNew York CityQuality-Adjusted Life YearsSensitivity and SpecificitySocioeconomic FactorsUrban Population

Identifiers

PMID18936502
PMCPMC4312002

What OpenQuestion holds

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Registered trials

None linked

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.