| Cost-effective management of patients following myocardial infarction: the impact of ischemia on alternative approaches. | |
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MedLine Citation:
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PMID: 2463593 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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R S Dittus; S D Roberts; J Adolph; S B Knoebel |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 11 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 1988 Nov |
Date Detail:
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Created Date: 1989-02-23 Completed Date: 1989-02-23 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2086-92 Citation Subset: IM |
Affiliation:
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Regenstrief Institute for Health Care, Indianapolis, Indiana 46202. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Disease
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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
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