Evidence map›Paper›PMID 31708060›Full record

Trial reportValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2019

Stroke Warning Information and Faster Treatment (SWIFT): Cost-Effectiveness of a Stroke Preparedness Intervention.

Elizabeth R Stevens, Eric Roberts, Heather Carman Kuczynski, Bernadette Boden-Albala

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 45% 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, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. 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

4 authors at 2 institutions in 1 country.

Elizabeth R StevensDepartment of Epidemiology, New York University College of Global Public Health, New York, NY, USA; Department of Population Health, New York University School of Medicine, New York, NY, USA. Electronic address: elizabeth.stevens@nyumc.org.
Eric RobertsDepartment of Epidemiology, New York University College of Global Public Health, New York, NY, USA.
Heather Carman KuczynskiDepartment of Epidemiology, New York University College of Global Public Health, New York, NY, USA.
Bernadette Boden-AlbalaDepartment of Epidemiology, New York University College of Global Public Health, New York, NY, USA.
New York College of Health Professions · USNew York University · US

Funding

SWIFT: Stroke Warning Information and Faster TreatmentP50NS049060 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI MOHR, JAY P · 2004 to 2013
$18.2M
Developing Optimal Dynamic Behavioral Intervention in Community-Based Studies.R01NS072127 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI CHEUNG, KEN · 2011 to 2013
$835k
NINDS NIH HHS P50 NS049060NINDS NIH HHS R01 NS072127
6 · The paper itself

Abstract

backgroundLess than 25% of stroke patients arrive to an emergency department within the 3-hour treatment window.

objectiveWe evaluated the cost-effectiveness of a stroke preparedness behavioral intervention study (Stroke Warning Information and Faster Treatment [SWIFT]), a stroke intervention demonstrating capacity to decrease race-ethnic disparities in ED arrival times.

methodsUsing the literature and SWIFT outcomes for 2 interventions, enhanced educational (EE) materials, and interactive intervention (II), we assess the cost-effectiveness of SWIFT in 2 ways: (1) Markov model, and (2) cost-to-outcome ratio. The Markov model primary outcome was the cost per quality-adjusted life-year (QALY) gained using the cost-effectiveness threshold of $100 000/QALY. The primary cost-to-outcome endpoint was cost per additional patient with ED arrival <3 hours, stroke knowledge, and preparedness capacity. We assessed the ICER of II and EE versus standard care (SC) from a health sector and societal perspective using 2015 USD, a time horizon of 5 years, and a discount rate of 3%.

resultsThe cost-effectiveness of the II and EE programs was, respectively, $227.35 and $74.63 per additional arrival <3 hours, $440.72 and $334.09 per additional person with stroke knowledge proficiency, and $655.70 and $811.77 per additional person with preparedness capacity. Using a societal perspective, the ICER for EE versus SC was $84 643 per QALY gained and the ICER for II versus EE was $59 058 per QALY gained. Incorporating fixed costs, EE and II would need to administered to 507 and 1693 or more patients, respectively, to achieve an ICER of $100 000/QALY.

conclusionII was a cost-effective strategy compared with both EE and SC. Nevertheless, high initial fixed costs associated with II may limit its cost-effectiveness in settings with smaller patient populations.

Indexed as

AgedCost-Benefit AnalysisFemaleHealth EducationHealth ServicesHumansMaleMarkov ChainsMiddle AgedModels, EconomicQuality-Adjusted Life YearsSocioeconomic FactorsStrokeTime FactorsTissue Plasminogen ActivatorTissue Plasminogen Activatoracute strokecost-effectivenesshealth literacypatient-centered outcomes researchpatient educationpreparedness

Identifiers

PMID31708060
PMCPMC6857539
OpenAlexW2964706002

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.