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Systematic review of cost-effectiveness of myocardial perfusion scintigraphy in patients with ischaemic heart disease
- Source :
- European Heart Journal-Cardiovascular Imaging, 18(8), 825-+. Oxford University Press
- Publication Year :
- 2017
-
Abstract
- Coronary artery disease (CAD) is a major cause of death and disability. Several diagnostic tests, such as myocardial perfusion scintigraphy (MPS), are accurate for the detection of CAD, as well as having prognostic value for the prediction of cardiovascular events. Nevertheless, the diagnostic and prognostic value of these tests should be cost-effective and should lead to improved clinical outcome. We have reviewed the literature on the cost-effectiveness of MPS in different circumstances: (i) the diagnosis and management of CAD; (ii) comparison with exercise electrocardiography (ECG) and other imaging tests; (iii) as gatekeeper to invasive coronary angiography (ICA), (iv) the impact of appropriate use criteria; (v) acute chest pain, and (vi) screening of asymptomatic patients with type-2 diabetes. In total 57 reports were included. Although most non-invasive imaging tests are cost-effective compared with alternatives, the data conflict on which non-invasive strategy is the most cost-effective. Different definitions of cost-effectiveness further confound the subject. Computer simulations of clinical diagnosis and management are influenced by the assumptions made. For instance, diagnostic accuracy is often defined against an anatomical standard that is wrongly assumed to be perfect. Conflicting data arise most commonly from these incorrect or differing assumptions.
- Subjects :
- medicine.medical_specialty
CLINICAL-OUTCOMES
Cost effectiveness
EMISSION COMPUTED-TOMOGRAPHY
030204 cardiovascular system & hematology
ECONOMIC-EVALUATION
Asymptomatic
Appropriate Use Criteria
law.invention
ischaemic heart disease
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Internal medicine
Diabetes mellitus
medicine
myocardial perfusion scintigraphy
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Cause of death
cost effectiveness
business.industry
DIAGNOSTIC STRATEGIES
General Medicine
Emergency department
RANDOMIZED CONTROLLED-TRIAL
medicine.disease
EMERGENCY-DEPARTMENT
CARDIOVASCULAR MAGNETIC-RESONANCE
Cardiology
CORONARY-ARTERY-DISEASE
medicine.symptom
STABLE CHEST-PAIN
ASYMPTOMATIC PATIENTS
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 20472404
- Volume :
- 18
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- European Heart Journal - Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....9164cdeac46d4129e459228e0094e660