Cost-effectiveness of Coronary CT Angiography versus Myocardial Perfusion SPECT for Evaluation of Patients with Chest Pain and No Known Coronary Artery Disease

Abstract

http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.09090349/-/DC1.

Impact of a Continuous Quality Improvement Initiative on Appropriate Use of Coronary Computed Tomography Angiography

“…In addition to defining the presence or absence of CAD, CCTA is cost-effective, provides diagnostic rapidity, and has excellent prognostic value in selected patients (8). Such characteristics combined with improved ease of interpretation have spurred widespread use and increased the potential for inappropriate use.…”

Cost‐effectiveness of Quantitative Pretest Probability Intended to Reduce Unnecessary Medical Radiation Exposure in Emergency Department Patients With Chest Pain and Dyspnea

“…The Consumer Price Index was used to adjust all costs to 2013 dollars. 39 [16][17][18] 0.083 NA Probability of death from recurrent PE 19,20 0.34 0.3-0.44 Probability of improved health after PE 0.2 NA Probability of ICH for those with PE 8,21,22 0.004 NA Probability of death from ICH for those with PE in year 1 8,21,23 0.45 0.21-0.72 Probability of death from ICH experienced after year 1 21,24 0.23 NA Probability of ICH in the general population 24 0.000292 0.000274-0.00031 MI and ischemic stroke Probability of MI in the medium risk population 25 0.015 0.012-0.018 Probability of MI recurrence (based on high risk population) 25 0.032 0.026-0.038 Probability that MI is nonfatal 26 0.55 0.44-0.66 Probability of improved health after MI 0.2 NA Probability of ischemic stroke 27 0.0027 NA Probability of death from first stroke within a year 28 0.0375 0.0302-0.0461 Probability of stroke recurrence 29 0.111 0.09-0.133 Probability of complete recovery within 1 year of stroke 30 0 Data Supplement S3 (available as supporting information in the online version of this paper) details other assumptions of the model. Five assumptions warrant specific consideration.…”

Coronary Artery Computed Tomography Scanning

“…7 Findings from cost-effectiveness analyses indicate that with CAD pretest probabilities of 10% to 50%, CCTA is more cost-effective than other imaging modalities. 8 As a result, current Appropriate Use Criteria 9 recommend CCTA for the diagnostic work-up of patients with stable angina but low to intermediate CAD likelihood, especially in the setting of equivocal prior study results. This indication chiefly encompasses the use of CCTA for clarifying abnormal findings at functional testing.…”