ArticleArquivos brasileiros de cardiologia2022
Cost-Effectiveness Analysis of CCTA in SUS, as Compared to Other Non-Invasive Imaging Modalities in Suspected Obstructive CAD.
Article in Arquivos brasileiros de cardiologia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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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.
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.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.
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- Cardiovascular Computed Tomography and Magnetic Resonance Imaging Guideline of the Brazilian Society of Cardiology and the Brazilian College of Radiology - 2024.Arquivos brasileiros de cardiologia · 2024Article
- Mindset Shift in Coronary Artery Disease: Reflections Triggered by the Diamond Anniversary of the Bruce Protocol.Arquivos brasileiros de cardiologia · 2023Article
- Cardiovascular Magnetic Resonance and Cardiovascular Computed Tomography in the Present and Future Cardiology.Arquivos brasileiros de cardiologia · 2023Article
- Cost-Effectiveness of Using the Coronary Calcium Score to Guide Therapeutic Decisions in Primary Prevention in the Brazilian Population.Arquivos brasileiros de cardiologia · 2022Article
- Role of Computed Tomography in Excluding Acute Coronary Syndrome: is Anatomy the Way?Arquivos brasileiros de cardiologia · 2022Article
- It is Time for Coronary Computed Tomography Angiography to be Incorporated into the SUS.Arquivos brasileiros de cardiologia · 2022Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Brazilian public health system does not include computed tomography angiography (CTA).
objectiveRank, according to the Brazilian public health system, the cost-effectiveness of different strategies for the diagnosis of coronary artery disease (CAD), combining exercise tests (ET), myocardial scintigraphy (MS), stress echocardiography (SE), and CTA in a hypothetical intermediate pre-test probability cohort of patients.
methodsThis study implemented a cost-effectiveness analysis through a decision tree. The incremental cost-effectiveness ratio (ICER) and net benefit were analyzed by adopting multiple thresholds of willingness to pay, from 0.05 to 1 GDP per capita per correct diagnosis. In sequential tests, a second confirmatory test was performed only when the first was positive.
resultsAfter excluding dominated or extended dominance diagnostic strategies, the efficiency frontier consisted of three strategies: ET, ET followed by SE, and SE followed by CTA, the last being the most cost-effective strategy. Through the net benefit, the ranking of the most cost-effective strategies varied according to willingness to pay.
conclusionsUsing current concepts of health technology assessment, this study provides a ranking for decision-making concerning which diagnostic strategy to use in a population with an intermediate pre-test risk for CAD. With a feasible cost estimate adopted for CTA, the impact of including this to the list of the diagnostic arsenal would represent a cost-effective strategy in most of the evaluated scenarios with broad variations in the willingness to pay.
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