Key result
In a decision model for suspected NSTE-ACS, an initial MDCTA strategy was cost-effective compared to standard observation for patients with a pre-test probability lower than 0.71 when using a 50% stenosis threshold.
Why the study?
Does multi-detector computed tomography angiography (MDCTA) improve cost-effectiveness compared to admission with classic clinical follow-up in patients with suspected NSTE-ACS with initially negative enzymes in the emergency department?
Does multi-detector computed tomography angiography (MDCTA) improve cost-effectiveness compared to admission with classic clinical follow-up in patients with suspected NSTE-ACS with initially negative enzymes in the emergency department?
A decision tree model suggests that MDCTA is likely a cost-effective strategy for diagnosing suspected NSTE-ACS with initially negative enzymes in the emergency department in Belgium.
MDCTA may be cost-effective in low-probability modeled NSTE-ACS; leaves open whether to alter observation pathways without prospective trials.
The purpose of our study is to model cost-effectiveness of MDCTA for the diagnosis of NSTE-ACS with initially negative enzymes, in the emergency department. In Belgium, the use of multi-detector computed tomography (MDCTA) is probably cost-effective in the diagnosis of NSTE-ACS in the acute setting A decision tree model was developed and a mathematical study was performed that included two hypothetical strategies: MDCTA and admission with classic clinical follow-up and treatment. Cost-effectiveness for the Belgian situation was simulated with sensitivity analysis using known values for diagnostic performance and known costs for the different strategies or components of strategies.
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Beule et al. (2010) studied Suspected non-ST elevation acute coronary syndrome (NSTE-ACS). Multi-detector computed tomography (MDCTA) vs. Admission with classic clinical follow-up and treatment (Observation) was evaluated on Cost per correct diagnosis of ACS. In a decision model for suspected NSTE-ACS, an initial MDCTA strategy was cost-effective compared to standard observation for patients with a pre-test probability lower than 0.71 when using a 50% stenosis threshold.
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