Document Detail


Cost-effective management of patients following myocardial infarction: the impact of ischemia on alternative approaches.
MedLine Citation:
PMID:  2463593     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Following uncomplicated myocardial infarction patients are at varying risk for cardiovascular morbidity and mortality. In order to identify and treat high risk patients, various management approaches can be employed. We performed a decision analysis to examine the cost-effectiveness of seven alternative strategies under the assumption that prognosis is affected by both the location of anatomic obstruction and the degree of myocardial ischemia. Strategies included combinations of angiography and two theoretical diagnostic tests capable of detecting ischemia with different degrees of accuracy. The strategy associated with the lowest overall six month mortality initiated testing with the diagnostic test most sensitive for ischemia, slightly better than proceeding initially to angiography. Initial use of a test sensitive for ischemia was also considerably more cost-effective than proceeding directly to angiography. Future analyses evaluating the role of diagnostic tests in coronary artery disease should incorporate the dimension of ischemia.
Authors:
R S Dittus; S D Roberts; J Adolph; S B Knoebel
Related Documents :
18651413 - Allergic myocardial infarction.
9822873 - Blood flow in myocardial hibernation.
1428293 - Surgical pathology of the mitral valve: gross and histological study of 1288 surgically...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  11     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1988 Nov 
Date Detail:
Created Date:  1989-02-23     Completed Date:  1989-02-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2086-92     Citation Subset:  IM    
Affiliation:
Regenstrief Institute for Health Care, Indianapolis, Indiana 46202.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Coronary Disease / economics*
Cost-Benefit Analysis
Costs and Cost Analysis
Decision Support Techniques*
Humans
Male
Middle Aged
Myocardial Infarction / economics*,  therapy
Prognosis
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Antihypertensive therapy for the elderly: an expert system to assist therapeutic decisions.
Next Document:  Diagnosis of paced electrocardiograms by inverse computer modeling of pacemaker actions.