| Impact of advanced exercise ECG analysis on cost of coronary artery disease management. | |
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MedLine Citation:
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PMID: 20545809 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Conventional analysis of exercise electrocardiogram (EX-ECG) has limited accuracy. This study aims to evaluate the potential impact of improving EX-ECG accuracy on costs of diagnosis and number of misdiagnoses of coronary artery disease (CAD). METHODS: A decision-tree model was simulated including sequential application of diagnostic procedures for suspected CAD. The model was structured in two main branches (presence or absence of CAD). A probabilistic sensitivity analysis was then performed for several combinations of improvement in test sensitivity and specificity. RESULTS: A clear trend in cost reduction was observed at improving EX-ECG specificity (about 8-8.5 million dollars, corresponding to a 5.6-7.6% reduction according to the prevalence level). Wrong diagnoses counted for 9-13% of test. Improvements in test parameters lead to reductions in wrong diagnoses, especially when increasing specificity (8.8-12.5%). CONCLUSIONS: A proper improvement in EX-ECG sensitivity and specificity would have a relevant impact on the costs of CAD management, while reducing the number of misdiagnoses. |
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Authors:
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Riccardo Bigi; Alberto Ferrando; Eva Pagano; Lauro Cortigiani; Franco Merletti; Cesare Fiorentini; Dario Gregori |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-06-10 |
Journal Detail:
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Title: Journal of evaluation in clinical practice Volume: 16 ISSN: 1365-2753 ISO Abbreviation: J Eval Clin Pract Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-27 Completed Date: 2010-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9609066 Medline TA: J Eval Clin Pract Country: England |
Other Details:
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Languages: eng Pagination: 678-84 Citation Subset: IM |
Affiliation:
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Cardiology, Department of Medicine and Surgery, University School of Medicine, Milan, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Artery Disease
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diagnosis,
economics* Costs and Cost Analysis Decision Trees Disease Management Electrocardiography / methods* Exercise Test* Humans Models, Theoretical Monte Carlo Method |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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