Evidence map›Paper›PMID 29110166›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2017

Effect of battery longevity on costs and health outcomes associated with cardiac implantable electronic devices: a Markov model-based Monte Carlo simulation.

Jordana K Schmier, Edmund C Lau, Jasmine D Patel, Juergen A Klenk, Arnold J Greenspon

Open access · hybridAbstract readComparative StudyEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 29% 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

4 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Jordana K SchmierExponent, Inc., 1800 Diagonal Road, Suite 500, Alexandria, VA, 22314, USA. jschmier@exponent.com.
Edmund C LauExponent, Inc., Menlo Park, CA, USA.
Jasmine D PatelExponent, Inc., Philadelphia, PA, USA.
Juergen A KlenkExponent, Inc., 1800 Diagonal Road, Suite 500, Alexandria, VA, 22314, USA.
Arnold J GreensponThomas Jefferson University, Philadelphia, PA, USA.
Exponent (United States) · USMenlo School · USThomas Jefferson University · US

Funding

Boston Scientific Corporation (US) grant to Exponent
6 · The paper itself

Abstract

introductionThe effects of device and patient characteristics on health and economic outcomes in patients with cardiac implantable electronic devices (CIEDs) are unclear. Modeling can estimate costs and outcomes for patients with CIEDs under a variety of scenarios, varying battery longevity, comorbidities, and care settings. The objective of this analysis was to compare changes in patient outcomes and payer costs attributable to increases in battery life of implantable cardiac defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-D). METHODS AND

resultsWe developed a Monte Carlo Markov model simulation to follow patients through primary implant, postoperative maintenance, generator replacement, and revision states. Patients were simulated in 3-month increments for 15 years or until death. Key variables included Charlson Comorbidity Index, CIED type, legacy versus extended battery longevity, mortality rates (procedure and all-cause), infection and non-infectious complication rates, and care settings. Costs included procedure-related (facility and professional), maintenance, and infections and non-infectious complications, all derived from Medicare data (2004-2014, 5% sample). Outcomes included counts of battery replacements, revisions, infections and non-infectious complications, and discounted (3%) costs and life years. An increase in battery longevity in ICDs yielded reductions in numbers of revisions (by 23%), battery changes (by 44%), infections (by 23%), non-infectious complications (by 10%), and total costs per patient (by 9%). Analogous reductions for CRT-Ds were 23% (revisions), 32% (battery changes), 22% (infections), 8% (complications), and 10% (costs).

conclusionBased on modeling results, as battery longevity increases, patients experience fewer adverse outcomes and healthcare costs are reduced. Understanding the magnitude of the cost benefit of extended battery life can inform budgeting and planning decisions by healthcare providers and insurers.

Indexed as

Cost SavingsHealth Care CostsAgedCardiac Resynchronization Therapy DevicesCost-Benefit AnalysisDefibrillators, ImplantableDevice RemovalElectric Power SuppliesEquipment FailureFemaleHeart FailureHumansMaleMedicareMiddle AgedMonte Carlo MethodBattery lifeCardiac resynchronization therapy devicesCosts and cost analysisDevice battery replacementDevice longevity

Identifiers

PMID29110166
PMCPMC5705743
OpenAlexW2767883730

What OpenQuestion holds

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LicenceCC BY
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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.