SwePub
Sök i LIBRIS databas

  Utökad sökning

WFRF:(Christ Michael)
 

Sökning: WFRF:(Christ Michael) > Economic evaluation...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005078naa a2200457 4500
001oai:DiVA.org:uu-342300
003SwePub
008180220s2017 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3423002 URI
0247 a https://doi.org/10.1371/journal.pone.01876622 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Ambavane, Apoorvau Modeling and Simulation, Evidera, London, United Kingdom4 aut
2451 0a Economic evaluation of the one-hour rule-out and rule-in algorithm for acute myocardial infarction using the high-sensitivity cardiac troponin T assay in the emergency department
264 c 2017-11-09
264 1b Public Library of Science (PLoS),c 2017
338 a electronic2 rdacarrier
500 a Correction in: PLoS ONE, vol. 13, issue 1, e0191348.DOI: 10.1371/journal.pone.0191348
520 a BACKGROUND: The 1-hour (h) algorithm triages patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED) towards "rule-out," "rule-in," or "observation," depending on baseline and 1-h levels of high-sensitivity cardiac troponin (hs-cTn). The economic consequences of applying the accelerated 1-h algorithm are unknown.METHODS AND FINDINGS: We performed a post-hoc economic analysis in a large, diagnostic, multicenter study of hs-cTnT using central adjudication of the final diagnosis by two independent cardiologists. Length of stay (LoS), resource utilization (RU), and predicted diagnostic accuracy of the 1-h algorithm compared to standard of care (SoC) in the ED were estimated. The ED LoS, RU, and accuracy of the 1-h algorithm was compared to that achieved by the SoC at ED discharge. Expert opinion was sought to characterize clinical implementation of the 1-h algorithm, which required blood draws at ED presentation and 1h, after which "rule-in" patients were transferred for coronary angiography, "rule-out" patients underwent outpatient stress testing, and "observation" patients received SoC. Unit costs were for the United Kingdom, Switzerland, and Germany. The sensitivity and specificity for the 1-h algorithm were 87% and 96%, respectively, compared to 69% and 98% for SoC. The mean ED LoS for the 1-h algorithm was 4.3h-it was 6.5h for SoC, which is a reduction of 33%. The 1-h algorithm was associated with reductions in RU, driven largely by the shorter LoS in the ED for patients with a diagnosis other than AMI. The estimated total costs per patient were £2,480 for the 1-h algorithm compared to £4,561 for SoC, a reduction of up to 46%.CONCLUSIONS: The analysis shows that the use of 1-h algorithm is associated with reduction in overall AMI diagnostic costs, provided it is carefully implemented in clinical practice. These results need to be prospectively validated in the future.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
7001 a Lindahl, Bertil,d 1957-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,UCR4 aut0 (Swepub:uu)belin227
7001 a Giannitsis, Evangelosu Medizinische Klinik III, University Heidelberg, Heidelberg, Germany4 aut
7001 a Roiz, Julieu Modeling and Simulation, Evidera, London, United Kingdom4 aut
7001 a Mendivil, Joanu Market Access, Roche Diagnostics International Ltd., Rotkreuz, Switzerland4 aut
7001 a Frankenstein, Lutzu Department of Cardiology, Angiology, Pulmonology, University Hospital of Heidelberg, Heidelberg, Germany4 aut
7001 a Body, Richardu Emergency Department, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom4 aut
7001 a Christ, Michaelu Department of Emergency and Critical Care Medicine, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany4 aut
7001 a Bingisser, Rolandu Emergency Department, University of Basel, University Hospital, Basel, Switzerland4 aut
7001 a Alquezar, Aitoru Servei de Urgencies. Hospital de Sant Pau, Barcelona, Spain4 aut
7001 a Mueller, Christianu Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland4 aut
7102 a Modeling and Simulation, Evidera, London, United Kingdomb Uppsala kliniska forskningscentrum (UCR)4 org
7730 t PLOS ONEd : Public Library of Science (PLoS)g 12:11q 12:11x 1932-6203
8564 u https://doi.org/10.1371/journal.pone.0187662y Fulltext
8564 u https://uu.diva-portal.org/smash/get/diva2:1184026/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
8564 u https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0187662&type=printable
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-342300
8564 8u https://doi.org/10.1371/journal.pone.0187662

Hitta via bibliotek

  • PLOS ONE (Sök värdpublikationen i LIBRIS)

Till lärosätets databas

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy