ArticlePloS one2014
Cost-effectiveness of thrombolysis within 4.5 hours of acute ischemic stroke in China.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses 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
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Quality of Health Economic Evaluations in Mainland China: A Comparison of Peer-Reviewed Articles in Chinese and in English.Applied health economics and health policy · 2022Pooled it
- The rate of early neurological deterioration occurring after thrombolytic therapy: A meta-analysis.Brain and behavior · 2019Pooled it
- Cost-effectiveness of mechanical thrombectomy within 6 hours of acute ischaemic stroke in China.BMJ open · 2018Pooled it
- HEADS UP 2024: Policy Efforts to Improve Equitable Access to Acute Stroke Care Globally.Journal of the American Heart Association · 2025Review
- Measuring the health outcomes of Chinese ischemic stroke patients based on the data from a longitudinal multi-center study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Observational
- Decomposing door-to-needle time: insights into workflow delays and quality improvement in acute stroke care.Frontiers in neurology · 2025Article
- Article
- The Cost and the Value of Stroke Care in Greece: Results from the SUN4P Study.Healthcare (Basel, Switzerland) · 2023Article
- Economic evaluation of intravenous alteplase for stroke with the time of onset between 4.5 and 9 hours.Journal of neurointerventional surgery · 2023Article
- The budget impact of alteplase in the treatment of acute ischemic stroke in Egypt.Frontiers in neurology · 2023Article
- Article
- Article
- Cost-effectiveness of edaravone dexborneol versus edaravone for the treatment of acute ischemic stroke in China: Based on the TASTE study.Frontiers in pharmacology · 2022Article
- GRP per capita and hospital characteristics associated with intravenous tissue plasminogen activator adherence rate: evidence from the Chinese Stroke Center Alliance.Stroke and vascular neurology · 2021Article
- A systematic review of the cost-effectiveness of emergency interventions for stroke in low- and middle-income countries.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2020Review
- Selection of essential medicines for the prevention and treatment of cardiovascular diseases in low and middle income countries.BMC cardiovascular disorders · 2018Article
- Impact of intravenous thrombolysis on length of hospital stay in cases of acute ischemic stroke.Neuropsychiatric disease and treatment · 2018Article
- Age-specific Cost Effectiveness of Using Intravenous Recombinant Tissue Plasminogen Activator for Treating Acute Ischemic Stroke.American journal of preventive medicine · 2017Article
- A cost-effective rabbit embolic stroke bioassay: insight into the development of acute ischemic stroke therapy.Translational stroke research · 2015Article
- A literature review of cost-effectiveness of intravenous recombinant tissue plasminogen activator for treating acute ischemic stroke.Stroke and vascular neurologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious economic studies conducted in developed countries showed intravenous tissue-type plasminogen activator (tPA) is cost-effective for acute ischemic stroke. The present study aimed to determine the cost-effectiveness of tPA treatment in China, the largest developing country.
methodsA combination of decision tree and Markov model was developed to determine the cost-effectiveness of tPA treatment versus non-tPA treatment within 4.5 hours after stroke onset. Outcomes and costs data were derived from the database of Thrombolysis Implementation and Monitor of acute ischemic Stroke in China (TIMS-China) study. Efficacy data were derived from a pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Costs and quality-adjusted life-years (QALYs) were compared in both short term (2 years) and long term (30 years). One-way and probabilistic sensitivity analyses were performed to test the robustness of the results.
resultsComparing to non-tPA treatment, tPA treatment within 4.5 hours led to a short-term gain of 0.101 QALYs at an additional cost of CNY 9,520 (US$ 1,460), yielding an incremental cost-effectiveness ratio (ICER) of CNY 94,300 (US$ 14,500) per QALY gained in 2 years; and to a long-term gain of 0.422 QALYs at an additional cost of CNY 6,530 (US$ 1,000), yielding an ICER of CNY 15,500 (US$ 2,380) per QALY gained in 30 years. Probabilistic sensitivity analysis showed that tPA treatment is cost-effective in 98.7% of the simulations at a willingness-to-pay threshold of CNY 105,000 (US$ 16,200) per QALY.
conclusionsIntravenous tPA treatment within 4.5 hours is highly cost-effective for acute ischemic strokes in China.
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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.