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  1. Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations : A cost-effectiveness analysis.

    Article - En anglais

    Background 

    Continuous-loop event recorders are widely used for the evaluation of palpitations, but the optimal duration of monitoring is unknown.

    Objective 

    To determine the yield, timing, and incremental cost-effectiveness of each week of event monitoring for palpitations.

    Design 

    Prospective cohort study.

    Patients 

    105 consecutive outpatients referred for the placement of a continuous-loop event recorder for the evaluation of palpitations.

    Measurements 

    Diagnostic yield, incremental cost, and cost-effectiveness for each week of monitoring.

    Results 

    The diagnostic yield of continuous-loop event recorders was 1.04 diagnoses per patient in week 1,0.15 diagnoses per patient in week 2, and 0.01 diagnoses per patient in week 3 and beyond.

    Over time, the cost-effectiveness ratio increased from $98 per new diagnosis in week 1 to $576 per new diagnosis in week 2 and $5832 per new diagnosis in week 3. Conclusions : In patients referred for evaluation of palpitations, the diagnostic yield of continuous-loop event recording decreases rapidly after 2 weeks of monitoring.

    A 2-week monitoring period is reasonably cost-effective for most patients and should be the standard period for continuous-loop event recording for the evaluation of palpitations.

    Mots-clés Pascal : Trouble rythme cardiaque, Electrocardiographie, Monitorage, Ambulatoire, Analyse coût efficacité, Economie santé, Etude longitudinale, Diagnostic, Homme, Appareil circulatoire pathologie, Cardiopathie, Electrodiagnostic

    Mots-clés Pascal anglais : Arrhythmia, Electrocardiography, Monitoring, Ambulatory, Cost efficiency analysis, Health economy, Follow up study, Diagnosis, Human, Cardiovascular disease, Heart disease, Electrodiagnosis

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0287265

    Code Inist : 002B12A02. Création : 27/11/1998.