Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease

James K. Min; Amanda Gilmore; Erica C. Jones; Daniel S. Berman; Wijnand J. Stuijfzand; Leslee J. Shaw; Ken O'Day; Ibrahim Danad

doi:10.1016/j.clinimag.2017.01.015

Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease

James K. Min, Amanda Gilmore, Erica C. Jones, Daniel S. Berman, Wijnand J. Stuijfzand, Leslee J. Shaw, Ken O'Day, Ibrahim Danad

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Purpose To determine lifetime cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain and suspected coronary artery disease (CAD). Methods Exercise treadmill testing (ETT), stress echocardiography (SE), myocardial perfusion scintigraphy (MPS), coronary computed tomographic angiography (CCTA), and invasive coronary angiography (ICA) were assessed alone, or in succession to each other. Results Initial ETT followed by imaging wherein ETT was equivocal or unable to be performed appeared more cost-effective than any strategy employing initial testing by imaging. Conclusion As pre-test likelihood of CAD varies, different modalities including SE, CCTA, and MPS result in improved costs and enhanced effectiveness.

Original language	English
Pages (from-to)	97-105
Number of pages	9
Journal	Clinical Imaging
Volume	43
DOIs	https://doi.org/10.1016/j.clinimag.2017.01.015
State	Published - 1 May 2017
Externally published	Yes

Keywords

Computed tomography
Cost effectiveness
Echocardiography
Invasive angiography
Myocardial perfusion SPECT
Stress testing

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10.1016/j.clinimag.2017.01.015

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title = "Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease",

abstract = "Purpose To determine lifetime cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain and suspected coronary artery disease (CAD). Methods Exercise treadmill testing (ETT), stress echocardiography (SE), myocardial perfusion scintigraphy (MPS), coronary computed tomographic angiography (CCTA), and invasive coronary angiography (ICA) were assessed alone, or in succession to each other. Results Initial ETT followed by imaging wherein ETT was equivocal or unable to be performed appeared more cost-effective than any strategy employing initial testing by imaging. Conclusion As pre-test likelihood of CAD varies, different modalities including SE, CCTA, and MPS result in improved costs and enhanced effectiveness.",

keywords = "Computed tomography, Cost effectiveness, Echocardiography, Invasive angiography, Myocardial perfusion SPECT, Stress testing",

author = "Min, {James K.} and Amanda Gilmore and Jones, {Erica C.} and Berman, {Daniel S.} and Stuijfzand, {Wijnand J.} and Shaw, {Leslee J.} and Ken O'Day and Ibrahim Danad",

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doi = "10.1016/j.clinimag.2017.01.015",

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T1 - Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease

AU - Min, James K.

AU - Gilmore, Amanda

AU - Jones, Erica C.

AU - Berman, Daniel S.

AU - Stuijfzand, Wijnand J.

AU - Shaw, Leslee J.

AU - O'Day, Ken

AU - Danad, Ibrahim

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Purpose To determine lifetime cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain and suspected coronary artery disease (CAD). Methods Exercise treadmill testing (ETT), stress echocardiography (SE), myocardial perfusion scintigraphy (MPS), coronary computed tomographic angiography (CCTA), and invasive coronary angiography (ICA) were assessed alone, or in succession to each other. Results Initial ETT followed by imaging wherein ETT was equivocal or unable to be performed appeared more cost-effective than any strategy employing initial testing by imaging. Conclusion As pre-test likelihood of CAD varies, different modalities including SE, CCTA, and MPS result in improved costs and enhanced effectiveness.

AB - Purpose To determine lifetime cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain and suspected coronary artery disease (CAD). Methods Exercise treadmill testing (ETT), stress echocardiography (SE), myocardial perfusion scintigraphy (MPS), coronary computed tomographic angiography (CCTA), and invasive coronary angiography (ICA) were assessed alone, or in succession to each other. Results Initial ETT followed by imaging wherein ETT was equivocal or unable to be performed appeared more cost-effective than any strategy employing initial testing by imaging. Conclusion As pre-test likelihood of CAD varies, different modalities including SE, CCTA, and MPS result in improved costs and enhanced effectiveness.

KW - Computed tomography

KW - Cost effectiveness

KW - Echocardiography

KW - Invasive angiography

KW - Myocardial perfusion SPECT

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Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease

Abstract

Keywords

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