Evidence map›Paper›PMID 9437275›Full record

Trial reportBMJ (Clinical research ed.)1997

The West of Scotland coronary prevention study: economic benefit analysis of primary prevention with pravastatin.

J Caro, W Klittich, A McGuire, I Ford, J Norrie, D Pettitt, J McMurray, J Shepherd

Open access · greenAbstract readClinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 1997. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 7 pooled it
19.5field-weighted citation impact, top 1% 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

44 citing papers in PubMed, 7 syntheses or guidelines pooled it, 203 citations in OpenAlex.

  1. Pooled it
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  4. Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2013 · on this map
    Pooled it
  5. Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2011 · on this map
    Pooled it
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  18. Cost-effectiveness of statins revisited: lessons learned about the value of innovation.The European journal of health economics : HEPAC : health economics in prevention and care · 2012
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

J CaroCaro Research, Concord, MA 01742, USA. jcaro@caroresearch.com
W Klittich
A McGuire
I Ford
J Norrie
D Pettitt
J McMurray
J Shepherd
University of Glasgow · GBBristol-Myers Squibb (Germany) · DECity, University of London · GBGlasgow Royal Infirmary · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo estimate the economic efficiency of using pravastatin to prevent the transition from health to cardiovascular disease in men with hypercholesterolaemia.

designEconomic benefit analysis based on data from the West of Scotland coronary prevention study. Treatment specific hazards of developing cardiovascular disease according to various definitions were estimated. Scottish record linkage data provided disease specific survival. Cost estimates were based on extracontractual tariffs and event specific average lengths of stay calculated from the West of Scotland coronary prevention study. SUBJECTS: Men with hypercholesterolaemia similar to the subjects in the West of Scotland coronary prevention study. MAIN OUTCOME: Cost consequences, the number of transitions from health to cardiovascular disease prevented, the number needed to start treatment, and cost per life year gained.

resultsIf 10,000 of these men started taking pravastatin, 318 of them would not make the transition from health to cardiovascular disease (number needed to treat, 31.4), at a net discounted cost of 20m Pounds over 5 years. These benefits imply an undiscounted gain of 2,460 years of life, and thus 8121 Pounds per life year gained, or 20,375 Pounds per life year gained if benefits are discounted. Restriction to the 40% of men at highest risk reduces the number needed to treat to 22.5 (5601 Pounds per life year gained (undiscounted) and 13,995 Pounds per life year gained (discounted)).

conclusionsIn subjects without evidence of prior myocardial infarction but who have hypercholesterolaemia, the use of pravastatin yields substantial health benefits at a cost that is not prohibitive overall and can be quite efficient in selected high risk subgroups.

Indexed as

Anticholesteremic AgentsCoronary DiseaseCost-Benefit AnalysisDrug CostsHumansHypercholesterolemiaMaleMiddle AgedMyocardial InfarctionPravastatinScotlandSensitivity and SpecificityTreatment OutcomeAnticholesteremic AgentsPravastatin

Identifiers

PMID9437275
PMCPMC2127969
OpenAlexW1981977618

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.