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  1. Diagnosis of suspected coronary artery disease in women : A cost-effectiveness analysis.

    Article - En anglais

    Background The optimal strategy for the diagnosis of coronary artery disease (CAD) in women is not well defined.

    We compared the cost-effectiveness of several strategies for diagnosing CAD in women with chest pain.

    Methods We performed decision and cost-effectiveness analyses with simulations of 55-year-old ambulatory women with chest pain.

    With a Markov model, simulations of patients underwent exercise electrocardiography, exercise testing with thallium scintigraphy, exercise echocardiography, angiography, or no workup.

    Results Diagnosis with angiography cost less than $17,000 per quality-adjusted life-year compared with exercise echocardiography if the patient had definite angina and less than $76,000 per life-year if she had probable angina.

    If she had nonspecific chest pain, diagnosis with exercise echocardiography increased life-years compared with no testing.

    Conclusions Cost-effectiveness of first-line diagnostic strategy for diagnosis of CAD in women varies mostly according to pretest probability of CAD.

    Diagnosis of coronary artery disease with angiography is cost-effective in 55-year-old women with definite angina.

    In 55-year-old women with probable angina, diagnosis with angiography would increase quality-adjusted life-years but significantly increase costs.

    Use of exercise echocardiography as a first-line diagnosis for CAD is cost effective in 55-year-old women with probable angina and nonspecific chest pain.

    Mots-clés Pascal : Cardiopathie coronaire, Analyse coût efficacité, Economie santé, Electrocardiographie, Epreuve effort, Scintigraphie, Angiographie, Etude longitudinale, Diagnostic, Homme, Appareil circulatoire pathologie, Electrodiagnostic, Exploration radioisotopique, Imagerie médicale, Radiodiagnostic

    Mots-clés Pascal anglais : Coronary heart disease, Cost efficiency analysis, Health economy, Electrocardiography, Exercise tolerance test, Scintigraphy, Angiography, Follow up study, Diagnosis, Human, Cardiovascular disease, Electrodiagnosis, Radionuclide study, Medical imagery, Radiodiagnosis

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

    Cote : 99-0329796

    Code Inist : 002B12A03. Création : 16/11/1999.