Evidence map›Paper›PMID 26874380›Full record

ArticleJACC. Heart failure2016

Cost-Effectiveness of Implantable Pulmonary Artery Pressure Monitoring in Chronic Heart Failure.

Alexander T Sandhu, Jeremy D Goldhaber-Fiebert, Douglas K Owens, Mintu P Turakhia, Daniel W Kaiser, Paul A Heidenreich

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Heart failure, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 6 pooled it
7.6field-weighted citation impact, top 2% 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.

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

50 citing papers in PubMed, 6 syntheses or guidelines pooled it, 103 citations in OpenAlex.

  1. Pooled it
  2. Implanted haemodynamic telemonitoring devices to guide management of heart failure: a review and meta-analysis of randomised trials.Clinical research in cardiology : official journal of the German Cardiac Society · 2023
    Pooled it
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  7. Trial
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  18. Hemodynamic Monitoring of Pediatric Patients With Heart Failure and Pulmonary Hypertension Using CardioMEMS.Journal of the Society for Cardiovascular Angiography & Interventions · 2024
    Article
  19. Ambulatory Hemodynamic Monitoring-Don't Forget the Little Ones!Journal of the Society for Cardiovascular Angiography & Interventions · 2024
    Article
  20. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Alexander T SandhuVeterans Affairs Palo Alto Health Care System, Palo Alto, California; Center for Health Policy and Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University, Stanford, California; Department of Medicine, Stanford University School of Medicine, Stanford, California. Electronic address: ats114@stanford.edu.
Jeremy D Goldhaber-FiebertCenter for Health Policy and Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University, Stanford, California.
Douglas K OwensVeterans Affairs Palo Alto Health Care System, Palo Alto, California; Center for Health Policy and Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University, Stanford, California.
Mintu P TurakhiaVeterans Affairs Palo Alto Health Care System, Palo Alto, California; Department of Medicine, Stanford University School of Medicine, Stanford, California.
Daniel W KaiserVeterans Affairs Palo Alto Health Care System, Palo Alto, California.
Paul A HeidenreichVeterans Affairs Palo Alto Health Care System, Palo Alto, California; Department of Medicine, Stanford University School of Medicine, Stanford, California.
VA Palo Alto Health Care System · USStanford University · US

Funding

T32 Training Program in Mechanisms and Innovation in Vascular DiseaseT32HL098049 · NHLBI · STANFORD UNIVERSITY · PI Nicholas James Leeper, Philip S Tsao · 2010 to 2026
$6.3M
Cost-effective chronic disease prevention in developing countriesK01AG037593 · NIA · STANFORD UNIVERSITY · PI GOLDHABER-FIEBERT, JEREMY DAVID · 2011 to 2015
$637k
Intramural VA VA999999NHLBI NIH HHS T32 HL098049NIA NIH HHS K01 AG037593
6 · The paper itself

Abstract

objectivesThis study aimed to evaluate the cost-effectiveness of the CardioMEMS (CardioMEMS Heart Failure System, St Jude Medical Inc, Atlanta, Georgia) device in patients with chronic heart failure.

backgroundThe CardioMEMS device, an implantable pulmonary artery pressure monitor, was shown to reduce hospitalizations for heart failure and improve quality of life in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial.

methodsWe developed a Markov model to determine the hospitalization, survival, quality of life, cost, and incremental cost-effectiveness ratio of CardioMEMS implantation compared with usual care among a CHAMPION trial cohort of patients with heart failure. We obtained event rates and utilities from published trial data; we used costs from literature estimates and Medicare reimbursement data. We performed subgroup analyses of preserved and reduced ejection fraction and an exploratory analysis in a lower-risk cohort on the basis of the CHARM (Candesartan in Heart failure: Reduction in Mortality and Morbidity) trials.

resultsCardioMEMS reduced lifetime hospitalizations (2.18 vs. 3.12), increased quality-adjusted life-years (QALYs) (2.74 vs. 2.46), and increased costs ($176,648 vs. $156,569), thus yielding a cost of $71,462 per QALY gained and $48,054 per life-year gained. The cost per QALY gained was $82,301 in patients with reduced ejection fraction and $47,768 in those with preserved ejection fraction. In the lower-risk CHARM cohort, the device would need to reduce hospitalizations for heart failure by 41% to cost <$100,000 per QALY gained. The cost-effectiveness was most sensitive to the device's durability.

conclusionsIn populations similar to that of the CHAMPION trial, the CardioMEMS device is cost-effective if the trial effectiveness is sustained over long periods. Post-marketing surveillance data on durability will further clarify its value.

Indexed as

AgedBlood Pressure Monitoring, AmbulatoryCost-Benefit AnalysisDisease ManagementFemaleHeart FailureHospitalizationHumansMaleMarkov ChainsMiddle AgedPulmonary ArteryQuality-Adjusted Life YearsStroke VolumeCardioMEMScost-effectivenessheart failuremonitoringtechnology

Identifiers

PMID26874380
PMCPMC4851610
OpenAlexW2256978350

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.