Evidence map›Paper›PMID 38244143›Full record

ArticlePharmacoEconomics - open2024

An Economic Evaluation of a Streamlined Day-Case Atrial Fibrillation Ablation Protocol and Conventional Cryoballoon Ablation versus Antiarrhythmic Drugs in a UK Paroxysmal Atrial Fibrillation Population.

Joe W E Moss, Derick Todd, Lukasz Grodzicki, Beatrice Palazzolo, Richard Mattock, Stuart Mealing, Maxim Souter, Benedict Brown, Tom Bromilow, Damian Lewis and 8 more

Open access · goldAbstract read
In one paragraph

Article in PharmacoEconomics - open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 17% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Cost Effectiveness of Catheter Ablation Versus Antiarrhythmic Drugs for Atrial Fibrillation: A Systematic Review and Meta-analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
    Pooled it
  2. Article
  3. 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

18 authors at 10 institutions in 3 countries.

Joe W E MossYork Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, YO10 5NQ, UK. joe.moss@york.ac.uk.
Derick ToddLiverpool Heart and Chest Hospital, Thomas Dr, Liverpool, L14 3PE, UK.
Lukasz GrodzickiYork Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, YO10 5NQ, UK.
Beatrice PalazzoloYork Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, YO10 5NQ, UK.
Richard MattockAcademic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Stuart MealingYork Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, YO10 5NQ, UK.
Maxim SouterMedtronic Limited, Watford, UK.
Benedict BrownMedtronic International Trading Sarl, Tolochenaz, Switzerland.
Tom BromilowYork Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, YO10 5NQ, UK.
Damian LewisYork Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, YO10 5NQ, UK.
James McCreadyBrighton and Sussex University Hospital, Brighton, UK.
Muzahir TayebjeeLeeds Teaching Hospitals NHS Trust, Leeds, UK.
Ewen ShepherdNewcastle-upon-Tyne NHS Foundation Trust, Newcastle, UK.
Thiagarajah SasikaranImperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK.
Clare CoyleNational Heart and Lung Institute, Imperial College London, London, UK.
Eleni IsmyrloglouMedtronic Bakken Research Center B.V., Maastricht, The Netherlands.
Nicholas A JohnsonImperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK.
Prapa KanagaratnamNational Heart and Lung Institute, Imperial College London, London, UK.
Leeds and York Partnership NHS Foundation Trust · GBImperial College Healthcare NHS Trust · GBImperial College London · GBLeeds Teaching Hospitals NHS Trust · GBMedtronic (Netherlands) · NLMedtronic (Switzerland) · CHMedtronic (United Kingdom) · GBNewcastle upon Tyne Hospitals NHS Foundation Trust · GBUniversity of Leeds · GBUniversity of Liverpool · GB

Funding

British Heart Foundation PG/15/36/31425
6 · The paper itself

Abstract

BACKGROUND AND

aimsSymptom control for atrial fibrillation can be achieved by catheter ablation or drug therapy. We assessed the cost effectiveness of a novel streamlined atrial fibrillation cryoballoon ablation protocol (AVATAR) compared with optimised antiarrhythmic drug (AAD) therapy and a conventional catheter ablation protocol, from a UK National Health Service (NHS) perspective.

methodsData from the AVATAR study were assessed to determine the cost effectiveness of the three protocols in a two-step process. In the first stage, statistical analysis of clinical efficacy outcomes was conducted considering either a three-way comparison (AVATAR vs. conventional ablation vs. optimised AAD therapies) or a two-way comparison (pooled ablation protocol data vs. optimised AAD therapies). In the second stage, models assessed the cost effectiveness of the protocols. Costs and some of the clinical inputs in the models were derived from within-trial cost analysis and published literature. The remaining inputs were derived from clinical experts.

resultsNo significant differences between the ablation protocols were found for any of the clinical outcomes used in the model. Results of a within-trial cost analysis show that AVATAR is cost-saving (£1279 per patient) compared with the conventional ablation protocol. When compared with optimised AAD therapies, AVATAR (pooled conventional and AVATAR ablation protocols efficacy) was found to be more costly while offering improved clinical benefits. Over a lifetime time horizon, the incremental cost-effectiveness ratio of AVATAR was estimated as £21,046 per quality-adjusted life-year gained (95% credible interval £7086-£71,718).

conclusionsThe AVATAR streamlined protocol is likely to be a cost-effective option versus both conventional ablation and optimised AAD therapy in the UK NHS healthcare setting.

Identifiers

PMID38244143
PMCPMC11058164
OpenAlexW4391060370

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.