• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

更新试验数据对经皮二尖瓣修复的成本效益的影响。

Impact of updated trial data on the cost-effectiveness of percutaneous mitral repair.

机构信息

Warwick Medical School, University of Warwick, Coventry, United Kingdom.

Chirurgie Cardio-Vasculaire et Transplantation Cardiaque, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon and Claude Bernard University, Lyon, France.

出版信息

PLoS One. 2023 Jan 26;18(1):e0280554. doi: 10.1371/journal.pone.0280554. eCollection 2023.

DOI:10.1371/journal.pone.0280554
PMID:36701304
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9879464/
Abstract

When updated clinical trial data becomes available reassessing the cost-effectiveness of technologies may modify estimates and influence decision-making. We investigated the impact of updated trial outcomes on the cost-effectiveness of percutaneous mitral repair (PR) for secondary mitral regurgitation. We updated our previous three-state time-varying Markov model to assess the cost-effectiveness of PR + guideline directed medical treatment (GDMT) versus GDMT alone. Key clinical inputs (overall survival (OS) and heart failure hospitalisations (HFH)) were obtained using the 3-year trial findings from the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy) RCT. We calculated incremental cost-effectiveness ratios (ICER) and report how these differ between analyses based on early (2-year) and updated (3-year) evidence. Updated trial data showed an increase in mortality in the intervention arm between two and three years follow-up that was not seen in the control arm. Deterministic and multivariate cost-effectiveness modelling yielded incremental cost effectiveness ratios ICERs of €38,123 and €31,227 /QALY. Compared to our 2-year based estimate (€21,918 / QALY) these results imply an approximate 1.5-fold increase in ICER. The availability of updated survival analyses from the COAPT pivotal trial suggests previous estimates based on 2-year trial findings were over optimistic for the intervention.

摘要

当更新的临床试验数据可用时，重新评估技术的成本效益可能会修改估计值并影响决策。我们调查了更新的试验结果对二尖瓣修复术（PR）治疗继发性二尖瓣反流的成本效益的影响。我们更新了我们之前的三状态时变马尔可夫模型，以评估 PR+指南指导的药物治疗（GDMT）与单独 GDMT 的成本效益。使用 COAPT（二尖瓣夹经皮治疗的心血管结局评估） RCT 的 3 年试验结果获得了关键临床输入（总生存（OS）和心力衰竭住院（HFH））。我们计算了增量成本效益比（ICER），并报告了基于早期（2 年）和更新（3 年）证据的分析之间的差异。更新的试验数据显示，干预组在两年至三年随访期间的死亡率增加，而对照组则没有。确定性和多变量成本效益建模得出的增量成本效益比 ICER 分别为 38123 欧元和 31227 欧元/QALY。与我们基于 2 年的估计（21918 欧元/QALY）相比，这些结果意味着 ICER 大约增加了 1.5 倍。COAPT 关键试验更新的生存分析的可用性表明，以前基于 2 年试验结果的估计值对干预措施过于乐观。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/dc3410a81fb5/pone.0280554.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/4103599ec47b/pone.0280554.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/0f548d1d2b13/pone.0280554.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/60e8a58a481f/pone.0280554.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/6bfddf8e6775/pone.0280554.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/be384b72d1b6/pone.0280554.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/dc3410a81fb5/pone.0280554.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/4103599ec47b/pone.0280554.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/0f548d1d2b13/pone.0280554.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/60e8a58a481f/pone.0280554.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/6bfddf8e6775/pone.0280554.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/be384b72d1b6/pone.0280554.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4c/9879464/dc3410a81fb5/pone.0280554.g006.jpg

相似文献

1
Impact of updated trial data on the cost-effectiveness of percutaneous mitral repair.更新试验数据对经皮二尖瓣修复的成本效益的影响。
PLoS One. 2023 Jan 26;18(1):e0280554. doi: 10.1371/journal.pone.0280554. eCollection 2023.
2
Cost-Effectiveness of Transcatheter Mitral Valve Repair Versus Medical Therapy in Patients With Heart Failure and Secondary Mitral Regurgitation: Results From the COAPT Trial.经导管二尖瓣修复术与心力衰竭并二尖瓣反流患者药物治疗的成本效益比较：来自 COAPT 试验的结果。
Circulation. 2019 Dec 3;140(23):1881-1891. doi: 10.1161/CIRCULATIONAHA.119.043275. Epub 2019 Sep 29.
3
Hospitalizations and Mortality in Patients With Secondary Mitral Regurgitation and Heart Failure: The COAPT Trial.伴有继发性二尖瓣反流和心力衰竭患者的住院和死亡情况：COAPT 试验。
J Am Coll Cardiol. 2022 Nov 15;80(20):1857-1868. doi: 10.1016/j.jacc.2022.08.803.
4
Conflicting findings between the Mitra-Fr and the Coapt trials: Implications regarding the cost-effectiveness of percutaneous repair for heart failure patients with severe secondary mitral regurgitation.Mitra-Fr 与 Coapt 试验结果相互矛盾：对重度继发性二尖瓣反流心力衰竭患者行经皮修复的成本效益的影响。
PLoS One. 2020 Nov 9;15(11):e0241361. doi: 10.1371/journal.pone.0241361. eCollection 2020.
5
Age-Related Outcomes After Transcatheter Mitral Valve Repair in Patients With Heart Failure: Analysis From COAPT.心力衰竭患者经导管二尖瓣修复术后的年龄相关转归：COAPT 分析。
JACC Cardiovasc Interv. 2022 Feb 28;15(4):397-407. doi: 10.1016/j.jcin.2021.11.037. Epub 2022 Jan 31.
6
Impact of COPD on Outcomes After MitraClip for Secondary Mitral Regurgitation: The COAPT Trial.COPD 对二尖瓣夹合术治疗继发性二尖瓣反流患者结局的影响：COAPT 试验。
JACC Cardiovasc Interv. 2020 Dec 14;13(23):2795-2803. doi: 10.1016/j.jcin.2020.09.023.
7
Association of Effective Regurgitation Orifice Area to Left Ventricular End-Diastolic Volume Ratio With Transcatheter Mitral Valve Repair Outcomes: A Secondary Analysis of the COAPT Trial.有效瓣口反流面积与左心室舒张末期容积比与经导管二尖瓣修复术结局的关系：COAPT 试验的二次分析。
JAMA Cardiol. 2021 Apr 1;6(4):427-436. doi: 10.1001/jamacardio.2020.7200.
8
Impact of Diabetes on Outcomes After Transcatheter Mitral Valve Repair in Heart Failure: COAPT Trial.糖尿病对心力衰竭经导管二尖瓣修复术后结局的影响：COAPT 试验。
JACC Heart Fail. 2021 Aug;9(8):559-567. doi: 10.1016/j.jchf.2021.03.011.
9
Sex-Specific Outcomes of Transcatheter Mitral-Valve Repair and Medical Therapy for Mitral Regurgitation in Heart Failure.经导管二尖瓣修复术与心力衰竭二尖瓣反流药物治疗的性别结局差异。
JACC Heart Fail. 2021 Sep;9(9):674-683. doi: 10.1016/j.jchf.2021.04.011. Epub 2021 Aug 11.
10
3-Year Outcomes of Transcatheter Mitral Valve Repair in Patients With Heart Failure.经导管二尖瓣修复术治疗心力衰竭患者的 3 年结果。
J Am Coll Cardiol. 2021 Mar 2;77(8):1029-1040. doi: 10.1016/j.jacc.2020.12.047.

引用本文的文献

1
Cost-effectiveness of percutaneous mitral repair for patients with severe secondary mitral regurgitation: an updated evaluation using a modelling approach based on COAPT final data after 5-year follow-up.经皮二尖瓣修复术治疗重度继发性二尖瓣反流患者的成本效益：基于COAPT 5年随访最终数据的建模方法的最新评估
BMJ Open. 2024 Dec 11;14(12):e087695. doi: 10.1136/bmjopen-2024-087695.
2
Potential impact on cost-effectiveness estimates of using immature survival data: a case study based on transcatheter edge-to-edge repair (TEER) used for patients with severe mitral regurgitation at high surgical risk.使用不成熟生存数据对成本效益估计的潜在影响：基于经导管缘对缘修复（TEER）用于高手术风险重度二尖瓣反流患者的案例研究。
BMJ Open. 2023 Mar 14;13(3):e060423. doi: 10.1136/bmjopen-2021-060423.

本文引用的文献

1
Cost-effectiveness of the MitraClip device in German heart failure patients with secondary mitral regurgitation.经二尖瓣修复装置治疗的德国心力衰竭伴继发性二尖瓣反流患者的成本效益分析。
Eur J Health Econ. 2023 Apr;24(3):349-358. doi: 10.1007/s10198-022-01476-4. Epub 2022 May 27.
2
Cost-effectiveness of transcatheter edge-to-edge repair in secondary mitral regurgitation.经导管缘对缘修复术治疗二尖瓣反流的成本效果分析。
Heart. 2022 May;108(9):717-724. doi: 10.1136/heartjnl-2021-320005. Epub 2022 Jan 25.
3
Prevalence of Immature Survival Data for Anti-Cancer Drugs Presented to the National Institute for Health and Care Excellence and Impact on Decision Making.
抗癌药物提交给英国国家卫生与临床优化研究所的不成熟生存数据的流行情况及其对决策的影响。
Value Health. 2021 Apr;24(4):505-512. doi: 10.1016/j.jval.2020.10.016. Epub 2020 Dec 8.
4
3-Year Outcomes of Transcatheter Mitral Valve Repair in Patients With Heart Failure.经导管二尖瓣修复术治疗心力衰竭患者的 3 年结果。
J Am Coll Cardiol. 2021 Mar 2;77(8):1029-1040. doi: 10.1016/j.jacc.2020.12.047.
5
COAPT-Like Profile Predicts Long-Term Outcomes in Patients With Secondary Mitral Regurgitation Undergoing MitraClip Implantation.类COAPT特征预测接受MitraClip植入术的继发性二尖瓣反流患者的长期预后。
JACC Cardiovasc Interv. 2021 Jan 11;14(1):15-25. doi: 10.1016/j.jcin.2020.09.050. Epub 2020 Dec 9.
6
Partitioned Survival and State Transition Models for Healthcare Decision Making in Oncology: Where Are We Now?肿瘤学中用于医疗保健决策的分区生存和状态转移模型：我们现在在哪里？
Value Health. 2020 Dec;23(12):1613-1621. doi: 10.1016/j.jval.2020.08.2094. Epub 2020 Oct 17.
7
An analysis of the cost-effectiveness of transcatheter mitral valve repair for people with secondary mitral valve regurgitation in the UK.英国经导管二尖瓣修复术治疗继发性二尖瓣反流的成本效果分析。
J Med Econ. 2020 Dec;23(12):1425-1434. doi: 10.1080/13696998.2020.1854769. Epub 2020 Dec 11.
8
Conflicting findings between the Mitra-Fr and the Coapt trials: Implications regarding the cost-effectiveness of percutaneous repair for heart failure patients with severe secondary mitral regurgitation.Mitra-Fr 与 Coapt 试验结果相互矛盾：对重度继发性二尖瓣反流心力衰竭患者行经皮修复的成本效益的影响。
PLoS One. 2020 Nov 9;15(11):e0241361. doi: 10.1371/journal.pone.0241361. eCollection 2020.
9
Cost-Effectiveness of Transcatheter Mitral Valve Repair Versus Medical Therapy in Patients With Heart Failure and Secondary Mitral Regurgitation: Results From the COAPT Trial.经导管二尖瓣修复术与心力衰竭并二尖瓣反流患者药物治疗的成本效益比较：来自 COAPT 试验的结果。
Circulation. 2019 Dec 3;140(23):1881-1891. doi: 10.1161/CIRCULATIONAHA.119.043275. Epub 2019 Sep 29.
10
Innovative valve disease therapies, a potential benefit for patients but calling for more clinical evaluation.
J Thorac Cardiovasc Surg. 2018 Dec;156(6):2138-2139. doi: 10.1016/j.jtcvs.2018.07.017.