Evidence map›Paper›PMID 34607343›Full record

SynthesisBlood advances2022

Cost-effectiveness of diagnostic strategies for venous thromboembolism: a systematic review.

Yuan Zhang, Housne A Begum, Himmat Grewal, Itziar Etxeandia-Ikobaltzeta, Gian Paolo Morgano, Rasha Khatib, Robby Nieuwlaat, Chengyi Ding, Wojtek Wiercioch, Reem A Mustafa and 2 more

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

Synthesis in Blood advances, 2022. 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
3.0field-weighted citation impact, top 8% 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, 20 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Article
  6. 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

12 authors at 6 institutions in 3 countries.

Yuan ZhangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Housne A BegumDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Himmat GrewalSUNY Upstate Medical Center, Syracuse, NY.
Itziar Etxeandia-IkobaltzetaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Gian Paolo MorganoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-7577-7963
Rasha KhatibAdvocate Research Institute, Advocate Health Care, Downers Grove, IL.
Robby NieuwlaatDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Chengyi DingResearch Department of Epidemiology and Public Health, University College London, London, UK.
Wojtek WierciochDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-6576-1650
Reem A MustafaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-2091-0875
Wendy LimDepartment of Medicine, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-2508-1786
Holger J SchünemannDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-3211-8479
Impact · CAAdvocate Health Care · USMcMaster University · CASUNY Upstate Medical University · USUniversity College London · GBUniversity of Kansas · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Guideline developers consider cost-effectiveness evidence in decision making to determine value for money. This consideration in the guideline development process can be informed either by formal and dedicated economic evaluations or by systematic reviews of existing studies. To inform the American Society of Hematology guideline on the diagnosis of venous thromboembolism (VTE), we conducted a systematic review focused on the cost-effectiveness of diagnostic strategies for VTE within the guideline scope. We systematically searched Medline (Ovid), Embase (Ovid), National Health Service Economic Evaluation Database, and the Cost-effectiveness Analysis Registry; summarized; and critically appraised the economic evidence on diagnostic strategies for VTE. We identified 49 studies that met our inclusion criteria, with 26 on pulmonary embolism (PE) and 24 on deep vein thrombosis (DVT). For the diagnosis of PE, strategies including d-dimer to exclude PE were cost-effective compared with strategies without d-dimer testing. The cost-effectiveness of computed tomography pulmonary angiogram (CTPA) in relation to ventilation-perfusion (V/Q) scan was inconclusive. CTPA or V/Q scan following ultrasound or d-dimer results could be cost-effective or even cost saving. For DVT, studies supporting strategies with d-dimer and/or ultrasound were cost-effective, supporting the recommendation that for patients at low (unlikely) VTE risk, using d-dimer as the initial test reduces the need for diagnostic imaging. Our systematic review informed the American Society of Hematology guideline recommendations about d-dimer, V/Q scan and CTPA for PE diagnosis, and d-dimer and ultrasound for DVT diagnosis.

Indexed as

Pulmonary EmbolismVenous ThromboembolismVenous ThrombosisCost-Benefit AnalysisHumansState Medicine

Identifiers

PMID34607343
PMCPMC8791567
OpenAlexW3204209359

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.