Comparing Spinal Cord Stimulation and Myocardial Laser Revascularisation for Angina
Author Information
Author(s): Dyer M T, Goldsmith K A, Khan S N, Sharples L D, Freeman C, Hardy I, Buxton M J, Schofield P M
Primary Institution: Health Economics Research Group, Brunel University
Hypothesis
This study aimed to compare the clinical outcomes and cost-effectiveness of Spinal Cord Stimulation (SCS) versus Percutaneous Myocardial Laser Revascularisation (PMR) in patients with refractory angina pectoris.
Conclusion
Outcomes after SCS did not differ appreciably from those after PMR, with SCS being less cost-effective as currently applied.
Supporting Evidence
- Patients that had SCS and PMR had similar exercise tolerance at 24 months.
- The difference in overall mean costs when comparing SCS to PMR was GBP5,520.
- The incremental cost-effectiveness ratio (ICER) of using SCS was GBP46,000 per QALY.
Takeaway
Doctors wanted to see if two treatments for chest pain worked differently. They found that one treatment didn't help more than the other, but one was more expensive.
Methodology
Patients were randomised to either SCS or PMR and followed for exercise tolerance, CCS classification, and quality of life measures at 3, 12, and 24 months.
Potential Biases
The study was conducted in a single centre, which may limit the generalizability of the results.
Limitations
The small sample size resulted in low precision, particularly in QALY estimates.
Participant Demographics
Patients had a mean age of approximately 64 years, with a majority being male (85% vs 91%).
Statistical Information
P-Value
0.96
Confidence Interval
95% CI GBP1,966 to GBP8,613
Statistical Significance
p < 0.01
Digital Object Identifier (DOI)
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