Potential cost effectiveness of initial myocardial perfusion imaging for assessment of emergency department patients with chest pain.
Previous investigations have confirmed the diagnostic and predictive usefulness of initial single-photon emission computed tomography (SPECT) myocardial perfusion imaging using technetium-99m sestamibi in the evaluation of emergency department patients with chest pain.
Patients with a normal SPECT perfusion scan performed during chest pain have an excellent short-term prognosis, and may be candidates for expeditious cardiac evaluation or outpatient management.
However, there are limited data regarding the cost effectiveness of this technique.
This analysis models the potential cost effectiveness of this procedure.
In the current investigation we compared 2 model strategies for management of emergency department patients with typical chest pain and a normal or nondiagnostic electrocardiogram (ECG).
In 1 model strategy, (the technetium-99m sestamibi SPECT myocardial perfusion imaging [SCAN] strategy), the decision whether to admit or discharge a patient from the emergency department is based on results of initial technetium-99m sestamibi SPECT myocardial imaging.
Patients with normal scans are discharged ; others are admitted.
In the second model strategy, (the NO SCAN strategy), the decision whether or not to admit a patient is based on a combination of clinical and electrocardiographic variables.
Patients with =3 cardiac risk factors or an abnormal ECG are admitted ; others are discharged. (...)
Mots-clés Pascal : Angine poitrine, Tomoscintigraphie, Photon, SAMU, Analyse coût efficacité, Economie santé, Exploration, Homme, Appareil circulatoire pathologie, Cardiopathie coronaire, Exploration radioisotopique
Mots-clés Pascal anglais : Angina pectoris, Emission tomography, Photon, Emergency medical care unit, Cost efficiency analysis, Health economy, Exploration, Human, Cardiovascular disease, Coronary heart disease, Radionuclide study
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0225814
Code Inist : 002B12A03. Création : 11/06/1997.