Evidence map›Paper›PMID 35387833›Full record

Trial reportBMJ open2022

Cost-effective analysis of mechanical thrombectomy alone in the treatment of acute ischaemic stroke: a Markov modelling study.

Mingyang Han, Yongkai Qin, Xin Tong, Linjin Ji, Songfeng Zhao, Lang Liu, Jigang Chen, Aihua Liu

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 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
2.0field-weighted citation impact, top 13% 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, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  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

8 authors at 3 institutions in 1 country.

Mingyang Han *Department of Neurosurgery, Central South University Third Xiangya Hospital, Changsha, Hunan, China.
Yongkai Qin *Department of Neurosurgery, Central South University Third Xiangya Hospital, Changsha, Hunan, China.
Xin TongBeijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Linjin JiDepartment of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Songfeng ZhaoDepartment of Neurosurgery, Central South University Third Xiangya Hospital, Changsha, Hunan, China.ORCID 0000-0003-3071-9115
Lang LiuDepartment of Neurosurgery, Central South University Third Xiangya Hospital, Changsha, Hunan, China.
Jigang ChenBeijing Neurosurgical Institute, Capital Medical University, Beijing, China liuaihuadoctor@163.com chenjigang2015@126.com.
Aihua LiuBeijing Neurosurgical Institute, Capital Medical University, Beijing, China liuaihuadoctor@163.com chenjigang2015@126.com.ORCID 0000-0002-6391-805X
Central South University · CNCapital Medical University · CNNanchang University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRecently, a randomised controlled trial (DIRECT-MT) demonstrated that mechanical thrombectomy (MT) was non-inferior to MT with intravenous alteplase as to the functional outcomes. This study aims to investigate whether MT alone is cost-effective compared with MT with alteplase in China.

methodsA Markov decision analytic model was built from the Chinese healthcare perspective using a lifetime horizon. Probabilities, costs and outcomes data were obtained from the DIRECT-MT trial and other most recent/comprehensive literature. Base case calculation was conducted to compare the costs and effectiveness between MT alone and MT with alteplase. One-way and probabilistic sensitivity analyses were performed to evaluate the robustness of the results.

resultsMT alone had a lower cost and higher effectiveness compared with MT with alteplase. The probabilistic sensitivity analysis demonstrated that, over a lifetime horizon, MT alone had a 99.5% probability of being cost-effective under the willingness-to-pay threshold of 1× gross domestic product per capita in China based on data obtained from the DIRECT-MT trial. These results remained robust under one-way sensitivity analysis.

conclusionsMT alone was cost-effective compared with MT with alteplase in China. However, cautions are needed to extend this conclusion to regions outside of China.

Indexed as

Brain IschemiaIschemic StrokeStrokeCost-Benefit AnalysisHumansMarkov ChainsQuality-Adjusted Life YearsThrombectomyTissue Plasminogen ActivatorTissue Plasminogen ActivatorHEALTH ECONOMICSNeurosurgeryStroke

Identifiers

PMID35387833
PMCPMC8987747
OpenAlexW4223423745

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.