Evidence map›Paper›PMID 31152027›Full record

ArticleBMJ open2019

Cost-minimisation analysis alongside a pilot study of early Tissue Doppler Evaluation of Diastolic Dysfunction in Emergency Department Non-ST Elevation Acute Coronary Syndromes (TEDDy-NSTEACS).

Vijay S Gc, Mohamad Alshurafa, David J Sturgess, Joseph Ting, Kye Gregory, Ana Sofia Oliveira Gonçalves, Jennifer A Whitty

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

Article in BMJ open, 2019. 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 32% 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, 5 citations in OpenAlex.

  1. Article
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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

7 authors at 2 institutions in 2 countries.

Vijay S GcCentre for Health Economics, University of York, York, UK.ORCID 0000-0003-0365-2605
Mohamad AlshurafaMater Research Institute, University of Queensland (MRI-UQ), South Brisbane, Queensland, Australia.
David J SturgessMater Research Institute, University of Queensland (MRI-UQ), South Brisbane, Queensland, Australia.ORCID 0000-0002-4364-0038
Joseph TingMater Research Institute, University of Queensland (MRI-UQ), South Brisbane, Queensland, Australia.
Kye GregoryMater Research Institute, University of Queensland (MRI-UQ), South Brisbane, Queensland, Australia.
Ana Sofia Oliveira GonçalvesNorwich Medical School, University of East Anglia, Norwich, UK.
Jennifer A WhittyNorwich Medical School, University of East Anglia, Norwich, UK.
The University of Queensland · AUUniversity of East Anglia · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo estimate the cost implications of early angiography for patients with suspected non-ST elevation acute coronary syndrome (NSTEACS) using tissue Doppler imaging (TDI).

designA decision tree model was used to synthesise data from the pilot study and literature sources. Sensitivity analyses tested the impact of assumptions incorporated into the analysis.

settingEmergency department (ED), Brisbane, Australia.

participantsPatients with suspected NSTEACS.

interventionsTDI as a diagnostic tool for triaging patients within 4 hours of presentation in addition to conventional risk stratification, compared with conventional risk stratification alone. DATA SOURCES: Resource used for diagnosis and management were recorded prospectively and costed for 51 adults who had echocardiography within 24 hours of admission. Costs for conventional care were based on observed data. Cost estimates for the TDI intervention assumed patients classified as high risk at TDI (E/e'>14) progressed early to angiography with an associated 1-day reduction in length of stay. PRIMARY OUTCOME MEASURES: Costs until discharge from the Australian healthcare perspective in 2016-2017 prices.

resultsFindings suggest that using TDI as a diagnostic tool for triaging patients with suspected NSTEACS is likely to be cost saving by $A1090 (95% credible interval: $A573 to $A1703) per patient compared with conventional care. The results are mainly driven by the assumed reduction in length of stay due to the inclusion of early TDI in clinical decision-making.

conclusionsThis pilot study indicates that compared with conventional risk stratification, triaging patients presenting with suspected NSTEACS with TDI within 4 hours of ED presentation has potential cost savings. Findings assume a reduction in hospital stay is achieved for patients considered to be high risk at TDI. Larger, comparative studies with longer follow-up are needed to confirm the clinical effectiveness of TDI as a diagnostic strategy for NSTEACS, the assumed reduction in hospital stay and any cost saving.

Indexed as

Costs and Cost AnalysisEchocardiography, DopplerAcute Coronary SyndromeAdultAgedAged, 80 and overDiastoleEmergency Service, HospitalFemaleHumansMaleMiddle AgedPilot ProjectsProspective Studiesacute coronary syndromecost-minimisationeconomic evaluationtissue doppler imaging

Identifiers

PMID31152027
PMCPMC6549746
OpenAlexW2947408188

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.