A systematic review and economic evaluation of new-generation computed tomography scanners for imaging in coronary artery disease and congenital heart disease: Somatom Definition Flash, Aquilion ONE, Brilliance iCT and Discovery CT750 HD

Abstract

Reports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Clinical Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.hta.ac.uk/ This reportThe research reported in this issue of the journal was commissioned and funded by the HTA programme on behalf of NICE as project number 10/107/01. The protocol was agreed in February 2011. The assessment report began editorial review in June 2011 and was accepted for publication in March 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by the NIHR Journals Library, produced by Prepress Projects Ltd, Perth, Scotland (www.prepress-projects.co.uk). Abstract A systematic review and economic evaluation of newgeneration computed tomography scanners for imaging in coronary artery disease and congenital heart disease: Somatom Definition Flash, Aquilion ONE, Brilliance iCT and Discovery CT750 HD NIHR Journals Library

Faecal immunochemical tests to triage patients with lower abdominal symptoms for suspected colorectal cancer referrals in primary care: a systematic review and cost-effectiveness analysis

“…This approach assumes that testing has no long-term (after 1 year) effect on costs or QALYs in diseasenegative people and is consistent with our approach taken in previous NICE diagnostic assessments. 112 We have assumed that, in patients without CRC, faecal occult blood testing would not significantly delay …”

Cost-effectiveness analysis of new generation coronary CT scanners for difficult-to-image patients

“…The characteristics (e.g. age, systolic blood pressure) of the difficult-to-image subgroups are based on the studies that are included in a systematic review [6]. The NGCCT has a different purpose in each population.…”

“…The cost-effectiveness analyses were conducted by combining five models which were adjusted for this specific decision problem: (1) a decision model of the diagnostic pathway (diagnostic model) [7], (2) a Markov model reflecting the prognosis of CAD patients [disease progression model (DPM) [8]], (3) a Markov model to estimate the impact of radiation on cancer mortality and morbidity [York Radiation Model (YRM) [6] [9]], (4) a Markov model to account for mortality amongst persons without CAD [general population model (GPM) [7]] and (5) a Markov model was created by the authors to estimate the impact of stroke due to the initial test and treatment (stroke model). The diagnostic model (Figs.…”

“…diagnostic, GPM, stroke, YRM and DPM) to derive a complete cost-effectiveness estimate for each specific difficult-to-image subgroup. In conclusion, the diagnostic model and the YRM was used for the entire cohort and the DPM, stroke and GPM were used depending on the test result and complications (Table 28 [6]). The aim of the study was to compare the overall cost-effectiveness of the three strategies in each of the two populations (suspected and known CAD).…”

Important Advances in Technology and Unique Applications to Cardiovascular Computed Tomography

“…Flagship MDCT models from major manufacturers and their key technologies are summarized in Table 1. 2 At present, the widest z-axis coverage of MDCT is 160 mm (320 detectors x 0.5 mm detector row width) in Aquilion ONE™ (Toshiba Medical Systems Corporation, Ōtawara, Japan). It allows the whole volume of the heart to be scanned axially within a single cardiac cycle.…”