原创力文档cost-effectiveness of new cardiac and vascular rehabilitation strategies for patients with coronary artery disease成本效益的新心脏和血管冠状动脉疾病患者的康复策略.pdfVIP
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cost-effectiveness of new cardiac and vascular rehabilitation strategies for patients with coronary artery disease成本效益的新心脏和血管冠状动脉疾病患者的康复策略
Cost-Effectiveness of New Cardiac and Vascular
Rehabilitation Strategies for Patients with Coronary
Artery Disease
1,2 1,2 3 3 1
Sandra Spronk *, Johanna L. Bosch , Constance Ryjewski , Judith Rosenblum , Guido C. Kaandorp ,
John V. White3,5, M. G. Myriam Hunink1,2,4
1 Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands, 2 Department of Radiology, Erasmus MC, Rotterdam, the Netherlands, 3 Department of Surgery,
Advocate Lutheran General Hospital, Chicago, Illinois, United States of America, 4 Department of Health Policy and Management, Harvard School of Public Health, Boston,
Massachusetts, United States of America, 5 Department of Surgery, University of Illinois College of Medicine, Chicago, Illinois, United States of America
Abstract
Objective: Peripheral arterial disease (PAD) often hinders the cardiac rehabilitation program. The aim of this study was
evaluating the relative cost-effectiveness of new rehabilitation strategies which include the diagnosis and treatment of PAD
in patients with coronary artery disease (CAD) undergoing cardiac rehabilitation.
Data Sources: Best-available evidence was retrieved from literature and combined with primary data from 231 patients.
Methods: We developed a Markov decision model to compare the following treatment strategies: 1. cardiac rehabilitation
only; 2. ankle-brachial index (ABI) if cardiac rehabilitation fails followed by diagnostic work-up and revascularization for PAD
if needed; 3. ABI prior to cardiac rehabilitation followed by diagnostic work-up and revascularization for PAD if needed.
Quality-adjusted-life years (QALYs), life-time costs (US $), incremental cost-effectiveness ratios (ICER), and gain in net health
benefits (NHB) in QALY
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