Evidence map›Paper›PMID 35301558›Full record

SynthesisEuropean radiology2022

A systematic review of cost-effectiveness analyses on endovascular thrombectomy in ischemic stroke patients.

Xiao Wu, Mihir Khunte, Dheeraj Gandhi, Pina Sanelli, Howard P Forman, Ajay Malhotra

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European radiology, 2022. 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
–field-weighted citation impact
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.

  1. Pooled it
  2. Observational
  3. A lifetime economic model of mortality and secondary care use for patients discharged from hospital following acute stroke.International journal of stroke : official journal of the International Stroke Society · 2025
    Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Xiao WuDepartment of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA.
Mihir KhunteDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, Box 208042, Tompkins East 2, 333 Cedar St, New Haven, CT, 06520-8042, USA.
Dheeraj GandhiDiagnostic Radiology and Nuclear Medicine, Neurology and Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Pina SanelliNorthwell School of Medicine at Hofstra University, 500 Hofstra Blvd, Hempstead, NY, 11549, USA.
Howard P FormanDepartment of Radiology and Biomedical Imaging, of Economics, of Management, and of Public Health, Yale University School of Medicine, New Haven, CT, USA.
Ajay MalhotraDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, Box 208042, Tompkins East 2, 333 Cedar St, New Haven, CT, 06520-8042, USA. ajay.malhotra@yale.edu.ORCID http://orcid.org/0000-0001-9223-6640

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of this study was to examine the published cost-effectiveness analyses (CEAs) on endovascular thrombectomy (EVT) in acute stroke patients, with a particular focus on the practice of accounting for costs and utilities.

methodsWe conducted a systematic review of published CEAs on EVT in acute stroke patients from 1/1/2009 to 10/1/2019. Published CEAs were searched in Ovid Embase, Ovid MEDLINE, and Web of Science. Cost or comparative effectiveness analyses were excluded. Risk of bias and quality assessment was based on the Consolidated Health Economic Evaluation Reporting Standard checklist.

resultsTwenty-one studies were included in the final analysis, from the USA, Canada, Europe, Asia, and Australia. They all concluded EVT to be cost-effective, but with significant variations in methodology. Fifteen studies employed a long-term horizon (> 20 years), while only 11 incorporated risk of recurrent strokes. The willingness-to-pay (WTP) threshold varied from $10,000/quality-adjusted life year (QALY) to $120,000/QALY, with $50,000/QALY and $100,000/QALY being the most commonly used. Five studies undertook a societal perspective, but only one accounted for indirect costs. Seventeen studies based outcomes on 90-day modified Rankin Scale (mRS) scores, and 9 of these 17 studies grouped outcomes by mRS 0-2 and 3-5. Among these 9 studies, the range of QALY score reported for mRS 0-2 was 0.71-0.85 QALY, and that of mRS 3-5 was 0.21-0.40.

conclusionsOur study reveals significant heterogeneity in previously published thrombectomy CEAs, highlighting need for better standardization in future CEAs. KEY POINTS: • All included studies concluded thrombectomy to be cost-effective, from both long- and short-term perspectives. • Only 5 out of 22 studies undertook a societal perspective, and only 1 accounted for indirect costs. • The range of value for mRS 0-2 was 0.71-0.85 quality-adjusted life year (QALY) and 0.21-0.40 QALY for mRS 3-5.

Indexed as

Ischemic StrokeStrokeCost-Benefit AnalysisHumansQuality-Adjusted Life YearsThrombectomyCost-benefit analysisQuality-adjusted life yearsStrokeThrombectomy

Identifiers

PMID35301558

What OpenQuestion holds

Textmetadata
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.