FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1965679905> ?p ?o ?g. }

• W1965679905 endingPage "65" @default.
• W1965679905 startingPage "54" @default.
• W1965679905 abstract "Background To compare cost-effectiveness and utility of four clinical algorithms to diagnose obstructive coronary atherosclerotic heart disease (CAD), we compared exercise ECG (ExECG), stress single photon emission computed tomography (SPECT), positron emission tomography (PET), and coronary angiography. Methods and Results Published data and a straightforward mathematical model based on Bayes’ theorem were used to compare strategies. Effectiveness was defined as the number of patients with diagnosed CAD, and utility was defined as the clinical outcome, ie, the number of quality-adjusted life years (QALY) extended by therapy after the diagnosis of CAD. Our model used published values for costs, accuracy, and complication rates of tests. Analysis of the model indicates the following results. (1) The direct cost (fee) for each test differs considerably from total cost per ΔQALY. (2) As pretest likelihood of CAD (pCAD) in the population increases, there is a linear increase in cost per patient tested but a hyperbolic decrease in cost per effect and cost per utility unit, ie, increased cost-effectiveness and decreased cost per utility unit. (3) At pCAD<0.70, analysis of the model indicates that stress PET is the most cost-effective test, with the lowest cost per utility, followed by SPECT, ExECG, and angiography, in that order. (4) Above a threshold value of pCAD of 0.70 (for example, middle-aged men with typical angina), proceeding directly to angiography as the first test showed the lowest cost per effect or utility. This quantitative model has the advantage of estimating a threshold value of pCAD (0.70) at which the rank order of cost-effectiveness and cost per utility unit change. The model also allows substitution of different values for any variable as a way to account for the uncertainties of clinical data, ie, changing costs, test accuracy and risk, etc. This procedure, called sensitivity analysis, showed that the rank order of cost-effectiveness did not change despite changes in several variables. Conclusions (1) Estimation of total costs of diagnostic tests for CAD requires consideration not only of the direct cost of the test per se (eg, test fees) but also of the indirect and induced costs of management algorithms based on the test (eg, cost/ΔQALY). (2) It is essential to consider the clinical history (pCAD) when selecting the clinical algorithm to make a diagnosis with the lowest cost per effect or cost per utility unit. (3) Stress PET shows the lowest cost per effect or cost per utility unit in patients with pCAD<0.70. (4) Angiography shows the lowest cost per effect or cost per utility unit in patients with pCAD>0.70." @default.
• W1965679905 created "2016-06-24" @default.
• W1965679905 creator A5010591524 @default.
• W1965679905 creator A5023283002 @default.
• W1965679905 creator A5036727603 @default.
• W1965679905 date "1995-01-01" @default.
• W1965679905 modified "2023-10-17" @default.
• W1965679905 title "Comparison of Cost-Effectiveness and Utility of Exercise ECG, Single Photon Emission Computed Tomography, Positron Emission Tomography, and Coronary Angiography for Diagnosis of Coronary Artery Disease" @default.
• W1965679905 cites W1513105146 @default.
• W1965679905 cites W1577273168 @default.
• W1965679905 cites W1970189439 @default.
• W1965679905 cites W1987291154 @default.
• W1965679905 cites W1990102973 @default.
• W1965679905 cites W1998237139 @default.
• W1965679905 cites W2028579495 @default.
• W1965679905 cites W2029996825 @default.
• W1965679905 cites W2045976183 @default.
• W1965679905 cites W2047190619 @default.
• W1965679905 cites W2065604703 @default.
• W1965679905 cites W2080628886 @default.
• W1965679905 cites W2092739738 @default.
• W1965679905 cites W2112506137 @default.
• W1965679905 cites W2141194644 @default.
• W1965679905 cites W2141265232 @default.
• W1965679905 cites W2158000104 @default.
• W1965679905 cites W2328513593 @default.
• W1965679905 cites W2809024510 @default.
• W1965679905 cites W4241262452 @default.
• W1965679905 cites W4248821053 @default.
• W1965679905 doi "https://doi.org/10.1161/01.cir.91.1.54" @default.
• W1965679905 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/7805219" @default.
• W1965679905 hasPublicationYear "1995" @default.
• W1965679905 type Work @default.
• W1965679905 sameAs 1965679905 @default.
• W1965679905 citedByCount "182" @default.
• W1965679905 countsByYear W19656799052012 @default.
• W1965679905 countsByYear W19656799052013 @default.
• W1965679905 countsByYear W19656799052014 @default.
• W1965679905 countsByYear W19656799052015 @default.
• W1965679905 countsByYear W19656799052016 @default.
• W1965679905 countsByYear W19656799052017 @default.
• W1965679905 countsByYear W19656799052019 @default.
• W1965679905 countsByYear W19656799052020 @default.
• W1965679905 countsByYear W19656799052021 @default.
• W1965679905 countsByYear W19656799052023 @default.
• W1965679905 crossrefType "journal-article" @default.
• W1965679905 hasAuthorship W1965679905A5010591524 @default.
• W1965679905 hasAuthorship W1965679905A5023283002 @default.
• W1965679905 hasAuthorship W1965679905A5036727603 @default.
• W1965679905 hasConcept C112930515 @default.
• W1965679905 hasConcept C126838900 @default.
• W1965679905 hasConcept C164705383 @default.
• W1965679905 hasConcept C174446222 @default.
• W1965679905 hasConcept C2775842073 @default.
• W1965679905 hasConcept C2777785093 @default.
• W1965679905 hasConcept C2778064278 @default.
• W1965679905 hasConcept C2778213512 @default.
• W1965679905 hasConcept C2778425758 @default.
• W1965679905 hasConcept C2780441642 @default.
• W1965679905 hasConcept C2780643987 @default.
• W1965679905 hasConcept C2908647359 @default.
• W1965679905 hasConcept C3019080777 @default.
• W1965679905 hasConcept C500558357 @default.
• W1965679905 hasConcept C71924100 @default.
• W1965679905 hasConcept C99454951 @default.
• W1965679905 hasConceptScore W1965679905C112930515 @default.
• W1965679905 hasConceptScore W1965679905C126838900 @default.
• W1965679905 hasConceptScore W1965679905C164705383 @default.
• W1965679905 hasConceptScore W1965679905C174446222 @default.
• W1965679905 hasConceptScore W1965679905C2775842073 @default.
• W1965679905 hasConceptScore W1965679905C2777785093 @default.
• W1965679905 hasConceptScore W1965679905C2778064278 @default.
• W1965679905 hasConceptScore W1965679905C2778213512 @default.
• W1965679905 hasConceptScore W1965679905C2778425758 @default.
• W1965679905 hasConceptScore W1965679905C2780441642 @default.
• W1965679905 hasConceptScore W1965679905C2780643987 @default.
• W1965679905 hasConceptScore W1965679905C2908647359 @default.
• W1965679905 hasConceptScore W1965679905C3019080777 @default.
• W1965679905 hasConceptScore W1965679905C500558357 @default.
• W1965679905 hasConceptScore W1965679905C71924100 @default.
• W1965679905 hasConceptScore W1965679905C99454951 @default.
• W1965679905 hasIssue "1" @default.
• W1965679905 hasLocation W19656799051 @default.
• W1965679905 hasLocation W19656799052 @default.
• W1965679905 hasOpenAccess W1965679905 @default.
• W1965679905 hasPrimaryLocation W19656799051 @default.
• W1965679905 hasRelatedWork W1574348006 @default.
• W1965679905 hasRelatedWork W1965679905 @default.
• W1965679905 hasRelatedWork W1972005328 @default.
• W1965679905 hasRelatedWork W2037621173 @default.
• W1965679905 hasRelatedWork W2054509747 @default.
• W1965679905 hasRelatedWork W2058079796 @default.
• W1965679905 hasRelatedWork W2080509779 @default.
• W1965679905 hasRelatedWork W2082824339 @default.
• W1965679905 hasRelatedWork W2135975603 @default.
• W1965679905 hasRelatedWork W2911729115 @default.
• W1965679905 hasVolume "91" @default.
• W1965679905 isParatext "false" @default.

• next