Evidence map›Paper›PMID 35135067›Full record

ArticleJournal of stroke2022

Cost-Effectiveness of Endovascular Thrombectomy in Childhood Stroke: An Analysis of the Save ChildS Study.

Wolfgang G Kunz, Peter B Sporns, Marios N Psychogios, Jens Fiehler, René Chapot, Franziska Dorn, Astrid Grams, Andrea Morotti, Patricia Musolino, Sarah Lee and 21 more

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

Article in Journal of stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 30% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

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

31 authors at 20 institutions in 5 countries.

Wolfgang G KunzDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany.
Peter B SpornsDepartment of Neuroradiology, Clinic for Radiology & Nuclear Medicine, University Hospital Basel, Switzerland.
Marios N PsychogiosDepartment of Neuroradiology, Clinic for Radiology & Nuclear Medicine, University Hospital Basel, Switzerland.
Jens FiehlerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
René ChapotDepartment of Neuroradiology, Alfried-Krupp Hospital, Essen, Germany.
Franziska DornDepartment of Neuroradiology, University Hospital Bonn, Bonn, Germany.
Astrid GramsDepartment of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.
Andrea MorottiNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Patricia MusolinoDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Sarah LeeDivision of Child Neurology, Department of Neurology, Stanford University, Stanford, CA, USA.
André KemmlingDepartment for Neuroradiology, University Hospital Marburg, Marburg, Germany.
Hans HenkesDepartment of Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany.
Omid NikoubashmanDepartment of Neuroradiology, Aachen University, Aachen, Germany.
Martin WiesmannDepartment of Neuroradiology, Aachen University, Aachen, Germany.
Ulf Jensen-KonderingDepartment of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Kiel, Germany.
Markus MöhlenbruchDepartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Marc SchlamannDepartment of Neuroradiology, University Hospital of Cologne, Cologne, Germany.
Wolfgang MarikDivision of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
Stefan SchobDepartment for Neuroradiology, University Hospital Leipzig, Leipzig, Germany.
Christina WendlDepartment of Radiology, University Hospital Regensburg, Regensburg, Germany.
Bernd TurowskiInstitute of Neuroradiology, University Hospital Duesseldorf, Duesseldorf, Germany.
Friedrich GötzDepartment of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.
Daniel KaiserDepartment of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany.
Konstantinos DimitriadisDepartment of Neurology, University Hospital, LMU Munich, Munich, Germany.
Alexandra GersingInstitute of Diagnostic and Interventional Neuroradiology, University Hospital, LMU Munich, Munich, Germany.
Thomas LiebigInstitute of Diagnostic and Interventional Neuroradiology, University Hospital, LMU Munich, Munich, Germany.
Jens RickeDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany.
Paul ReidlerDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany.
Moritz WildgruberDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany.
Sebastian MönchDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany.
Save ChildS InvestigatorsDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany.
LMU Klinikum · DERWTH Aachen University · DEUniversität Hamburg · DEAlfried Krupp Hospital · DEDüsseldorf University Hospital · DEHarvard University · USHeidelberg University · DEInnsbruck Medical University · ATKlinikum Stuttgart · DEMedical University of Vienna · ATMedizinische Hochschule Hannover · DEPhilipps University of Marburg · DEStanford University · USUniversity Hospital Bonn · DEUniversity Hospital Carl Gustav Carus · DEUniversity Hospital Cologne · DEUniversity Hospital Leipzig · DEUniversity Hospital of Basel · CHUniversity Hospital Regensburg · DEUniversity Hospital Schleswig-Holstein · DE

Funding

BaltBayerGuerbetStrykerStryker Neurovascular
6 · The paper itself

Abstract

background and purposeThe Save ChildS Study demonstrated that endovascular thrombectomy (EVT) is a safe treatment option for pediatric stroke patients with large vessel occlusions (LVOs) with high recanalization rates. Our aim was to determine the long-term cost, health consequences and cost-effectiveness of EVT in this patient population.

methodsIn this retrospective study, a decision-analytic Markov model estimated lifetime costs and quality-adjusted life years (QALYs). Early outcome parameters were based on the entire Save ChildS Study to model the EVT group. As no randomized data exist, the Save ChildS patient subgroup with unsuccessful recanalization was used to model the standard of care group. For modeling of lifetime estimates, pediatric and adult input parameters were obtained from the current literature. The analysis was conducted in a United States setting applying healthcare and societal perspectives. Probabilistic sensitivity analyses were performed. The willingness-to-pay threshold was set to $100,000 per QALY.

resultsThe model.

resultsyielded EVT as the dominant (cost-effective as well as cost-saving) strategy for pediatric stroke patients. The incremental effectiveness for the average age of 11.3 years at first stroke in the Save ChildS Study was determined as an additional 4.02 lifetime QALYs, with lifetime cost-savings that amounted to $169,982 from a healthcare perspective and $254,110 when applying a societal perspective. Acceptability rates for EVT were 96.60% and 96.66% for the healthcare and societal perspectives.

conclusionsEVT for pediatric stroke patients with LVOs resulted in added QALY and reduced lifetime costs. Based on the available data in the Save ChildS Study, EVT is very likely to be a cost-effective treatment strategy for childhood stroke.

Indexed as

Cost-benefit analysisPediatricsStrokeThrombectomy

Identifiers

PMID35135067
PMCPMC8829473
OpenAlexW4210455094

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.