ArticlePloS one2015
Electrocardiographic Screening for Prolonged QT Interval to Reduce Sudden Cardiac Death in Psychiatric Patients: A Cost-Effectiveness Analysis.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- The Use of Expert Elicitation among Computational Modeling Studies in Health Research: A Systematic Review.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Pooled it
- The relationship between 24-hour QT interval variability and heart rate variability in patients with acute myocardial infarction and the occurrence of major cardiovascular adverse events after PCI surgery.BMC cardiovascular disorders · 2025Article
- Determining sensitivity and specificity of risk scores for QTc interval prolongation in hemato-oncology patients prescribed systemic antifungal therapy: a retrospective cross-sectional study.International journal of clinical pharmacy · 2024Article
- A polygenic risk score for the QT interval is an independent predictor of drug-induced QT prolongation.PloS one · 2024Article
- Electrocardiogram abnormalities and associated factors among psychiatric patients attending follow up at Jimma Medical Center Psychiatry Clinic, Jimma, Ethiopia: an institution-based cross-sectional study.BMC cardiovascular disorders · 2023Article
- Prediction of Drug-Induced Long QT Syndrome Using Machine Learning Applied to Harmonized Electronic Health Record Data.Journal of cardiovascular pharmacology and therapeutics · 2021Article
- Developing a reference protocol for structured expert elicitation in health-care decision-making: a mixed-methods study.Health technology assessment (Winchester, England) · 2021Review
- Assessing Prescriber Behavior with a Clinical Decision Support Tool to Prevent Drug-Induced Long QT Syndrome.Applied clinical informatics · 2021Article
- Prevalence of QTc interval prolongation and its associated risk factors among psychiatric patients: a prospective observational study.BMC psychiatry · 2020Observational
- Cost-effectiveness of HLA-DQB1/HLA-B pharmacogenetic-guided treatment and blood monitoring in US patients taking clozapine.The pharmacogenomics journal · 2019Article
- Population Prevalence and Correlates of Prolonged QT Interval: Cross-Sectional, Population-Based Study From Rural Uganda.Global heart · 2019Article
- A literature-based algorithm for the assessment, management, and monitoring of drug-induced QTc prolongation in the psychiatric population.Neuropsychiatric disease and treatment · 2019Review
- Prevalence of ECG abnormalities and risk factors for QTc interval prolongation in hospitalized psychiatric patients.Therapeutic advances in psychopharmacology · 2019Article
- Experiences of Structured Elicitation for Model-Based Cost-Effectiveness Analyses.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2018Review
- Drug safety of macrolide and quinolone antibiotics in a tertiary care hospital: administration of interacting co-medication and QT prolongation.European journal of clinical pharmacology · 2016Observational
- Evaluation of the use of electrocardiogram monitoring in patients on psychotropic medications that have a risk of QT prolongation.The mental health clinician · 2016Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceSudden cardiac death is a leading cause of mortality in psychiatric patients. Long QT (LQT) is common in this population and predisposes to Torsades-de-Pointes (TdP) and subsequent mortality.
objectiveTo estimate the cost-effectiveness of electrocardiographic screening to detect LQT in psychiatric inpatients. DESIGN, SETTING, AND
participantsWe built a decision analytic model based on a decision tree to evaluate the cost-effectiveness and utility of LQT screening from a health care perspective. LQT proportion parameters were derived from an in-hospital cross-sectional study. We performed experts' elicitation to estimate the risk of TdP, given extent of QT prolongation. A TdP reduction of 65% after LQT detection was based on positive drug dechallenge rate and through adequate treatment and electrolyte adjustments. The base-case model uncertainty was assessed with one-way and probabilistic sensitivity analyses. Finally, the TdP related mortality and TdP avoidance parameters were varied in a two-way sensitivity analysis to assess their effect on the Incremental Cost-Effectiveness Ratio (ICER). MAIN OUTCOMES AND MEASURES: Costs, Quality Ajusted Life Year (QALY), ICER, and probability of cost effectiveness thresholds ($ 10,000, $25,000, and $50,000 per QALY).
resultsIn the base-case scenario, the numbers of patients needed to screen were 1128 and 2817 to avoid one TdP and one death, respectively. The ICER of systematic ECG screening was $8644 (95%CI, 3144-82 498) per QALY. The probability of cost-effectiveness was 96% at a willingness-to-pay of $50,000 for one QALY. In sensitivity analyses, results were sensitive to the case-fatality of TdP episodes and to the TdP reduction following the diagnosis of LQT. CONCLUSION AND RELEVANCE: In psychiatric hospitals, performing systematic ECG screening at admission help reduce the number of sudden cardiac deaths in a cost-effective fashion.
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