Cost-Effectiveness of Strategies for Diagnosing Acute Aortic Syndrome
Author Information
Author(s): Thokala Praveen, Goodacre Steve, Cooper Graham, Hinchliffe Robert, Reed Matthew J, Thomas Steven, Wilson Sarah, Fowler Catherine, Lechene Valérie
Primary Institution: The University of Sheffield
Hypothesis
Can clinical probability scoring and D-dimer testing improve the cost-effectiveness of diagnosing acute aortic syndrome?
Conclusion
Using ADD-RS>1 or ADD-RS=1 with D-dimer >500 ng/mL to select patients for CTA is cost-effective but requires further research to validate in practice.
Supporting Evidence
- AAS requires urgent diagnosis with CTA, which is costly and carries risks.
- Strategies using ADD-RS and D-dimer can improve diagnostic efficiency.
- Cost-effectiveness varies significantly based on the prevalence of AAS.
Takeaway
Doctors can use a scoring system and a blood test to decide who needs a special scan for a serious heart problem, which can save money and help more people.
Methodology
A decision analytical model was developed to simulate the management of patients with possible acute aortic syndrome using clinical scoring and D-dimer testing.
Potential Biases
Potential bias in clinician judgment regarding patient risk assessment for AAS.
Limitations
The study did not assess how clinicians determine the need for testing and excluded patients unlikely to benefit from surgery.
Participant Demographics
The hypothetical population had a mean age of 63 years, with a prevalence of AAS estimated at 0.26%.
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website