Evidence map›Paper›PMID 30092774›Full record

ArticleBMC cardiovascular disorders2018

An early analysis of cost-utility of baroreflex activation therapy in advanced chronic heart failure in Germany.

Oleg Borisenko, Jochen Müller-Ehmsen, JoAnn Lindenfeld, Erik Rafflenbeul, Christian Hamm

Open access · goldAbstract read
In one paragraph

Article in BMC cardiovascular disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 19% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Neuromodulation devices for heart failureEuropean heart journal supplements : journal of the European Society of Cardiology · 2022
    Article
  5. Review
  6. Stress and the "extended" autonomic system.Autonomic neuroscience : basic & clinical · 2021
    Review
  7. Article
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 5 institutions in 3 countries.

Oleg BorisenkoSynergus AB, Danderyd (Stockholm), Sweden. oleg.borisenko@synergus.com.ORCID 0000-0002-1361-2431
Jochen Müller-EhmsenDepartment of Internal Medicine 3, Asklepios Klinik Altona, Hamburg, Germany.
JoAnn LindenfeldHeart Failure and Transplantation Section Vanderbilt Heart and Vascular Institute Medical Center, Nashville, TN, USA.
Erik RafflenbeulDepartment of Internal Medicine 1, Asklepios Klinik Barmbek, Hamburg, Germany.
Christian HammKerckhoff Heart and Thoraxcenter, Bad Nauheim and Medical Clinic I, University of Giessen, Giessen, Germany.
Asklepios Klinik Altona · DEAsklepios Klinik Barmbek · DEJustus-Liebig-Universität Gießen · DESynergetics (Belgium) · BEVanderbilt University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to evaluate cost-utility of baroreflex activation therapy (BAT) using the Barostim neo™ device (CVRx Inc., Minneapolis, MN, USA) compared with optimized medical management in patients with advanced chronic heart failure (NYHA class III) who were not eligible for treatment with cardiac resynchronization therapy, from a statutory health insurance perspective in Germany over a lifetime horizon.

methodsA decision analytic model was developed using the combination of a decision tree and the Markov process. The model included transitions between New York Heart Association (NYHA) health states, each of which is associated with a risk of mortality, hospitalization, cost, and quality of life. The effectiveness of BAT was projected through relative risks for mortality (obtained by application of patient-level data to the Meta-analysis Global Group in Chronic Heart Failure risk prediction model) and hospitalization owing to worsening of heart failure (obtained from BAT Randomized Clinical Trial). All patients were in NYHA class III at baseline.

resultsBAT led to an incremental cost of €33,185 (95% credible interval [CI] €24,561-38,637) and incremental benefits of 1.78 [95% CI 0.45-2.71] life-years and 1.19 [95% CI 0.30-1.81] quality-adjusted life-years (QALYs). This resulted in an incremental cost-effectiveness ratio of €27,951/QALY (95% CI €21,357-82,970). BAT had a 59% probability of being cost-effective at a willingness-to-pay threshold of €35,000/QALY (but 84% at a threshold of €52,000/QALY).

conclusionsBAT can be cost-effective in European settings in those not eligible for cardiac resynchronization therapy among patients with advanced heart failure.

Indexed as

BaroreflexHealth Care CostsChronic DiseaseCost-Benefit AnalysisDecision Support TechniquesDecision TreesDisease ProgressionElectric Stimulation TherapyGermanyHeart FailureHumansImplantable NeurostimulatorsMarkov ChainsModels, EconomicPressoreceptorsQuality-Adjusted Life YearsBaroreflex activation therapyBarostimCost-utilityGermanyHealth economicsMarkov modeling

Identifiers

PMID30092774
PMCPMC6085633
OpenAlexW2887868673

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.