Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, ON L8P 1H1, Canada.
Expert Rev Pharmacoecon Outcomes Res. 2013 Oct;13(5):675-90. doi: 10.1586/14737167.2013.838079.
Conventional coronary angiography (CCA) is the standard diagnostic for coronary artery disease (CAD), but multi-detector computed tomography coronary angiography (CTCA) is a non-invasive alternative.
A multi-center coverage with evidence development study was undertaken and combined with an economic model to estimate the cost-effectiveness of CTCA followed by CCA vs CCA alone. Alternative assumptions were tested in patient scenario and sensitivity analyses.
CCA was found to dominate CTCA, however, CTCA was relatively more cost-effective in females, in advancing age, in patients with lower pre-test probabilities of CAD, the higher the sensitivity of CTCA and the lower the probability of undergoing a confirmatory CCA following a positive CTCA.
RESULTS were very sensitive to alternative patient populations and modeling assumptions. Careful consideration of patient characteristics, procedures to improve the diagnostic yield of CTCA and selective use of CCA following CTCA will impact whether CTCA is cost-effective or dominates CCA.
本研究旨在通过一项多中心覆盖范围的证据开发研究，并结合经济模型，评估 CTCA 后行 CCA 与单纯 CCA 的成本效益。本研究还对不同的假设情况进行了患者方案和敏感性分析。
研究结果对不同的患者人群和模型假设非常敏感。仔细考虑患者特征、提高 CTCA 诊断率的程序以及 CTCA 后有选择性地使用 CCA，将影响 CTCA 是否具有成本效益或优于 CCA。
本研究采用了一项多中心覆盖范围的证据开发研究，并结合经济模型，评估了 CTCA 后行 CCA 与单纯 CCA 的成本效益。本研究还对不同的假设情况进行了患者方案和敏感性分析。
单纯 CCA 优于 CTCA，但在女性、高龄、CAD 低预测试验概率患者、CTCA 敏感度较高以及 CTCA 阳性后行确诊性 CCA 概率较低的情况下，CTCA 则更具成本效益。
传统冠状动脉造影（CCA）是冠心病（CAD）的标准诊断方法，但多排螺旋 CT 冠状动脉造影（CTCA）是一种非侵入性的替代方法。
