Information statementCost-effectiveness of myocardial perfusion imaging: A summary of the currently available literature
Section snippets
Executive summary
This literature review presents evidence that myocardial perfusion imaging (MPI), single photon emission computed tomography (SPECT), is cost-effective when compared with other diagnostic modalities. This is particularly the case with respect to the patient who appears by clinical criteria to be at intermediate risk, in which SPECT can accurately both diagnose and risk stratify for coronary artery disease (CAD). By diagnosing and then stratifying risk, SPECT can efficiently distinguish patients
Background on cost-effectiveness analysis
Over the last decade, there has been a movement in medicine toward requiring a sufficient evidence base to justify the cost of any procedure or therapy. This movement of evidence-based medicine began as a result of dramatic increases in the costs of health care that far outpaced inflation and encumbered greater percentages of our gross domestic product. Detailed analysis of health care costs over the past few decades has shown tremendous growth in the use of medical procedures. Recent updates
Methods
Circulation, American Journal of Cardiology, Journal of Nuclear Cardiology, Journal of the American Society of Echocardiography, Journal of the American College of Cardiology, and Journal of Nuclear Medicine were surveyed for articles relating to topics on cost-effectiveness and MPI or SPECT imaging, by using conventional search engines such as PubMed and OVID. Two journals, Journal of Nuclear Cardiology and Journal of the American Society of Echocardiography, were surveyed from 1996 to 2004;
Conclusions
The cost-effectiveness of MPI has been demonstrated in a number of clinical studies and various patient populations. Although some simulation models are mixed with regard to the benefit of SPECT vs echocardiography, contemporary research increasingly highlights the greater accuracy of SPECT as an important factor in reducing downstream costs when compared with exercise ECG. Large cohort studies (END, EMPIRE) are also available, comparing SPECT with other diagnostic modalities. The results
Acknowledgments
Dr Shaw has grant support from Fujisawa Healthcare, GE-Amersham, and BMS- Medical Imaging. Dr Williams has grant support from Astellas, GE-Amersham, BMS-Medical Imaging, CV Therapeutics, and King Pharmaceuticals.
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2018, Journal of the American Society of EchocardiographyCitation Excerpt :The concept that MP imaging can improve cost-effectiveness in patients presenting to the ED with chest pain was first established using single-photon emission computed tomographic radionuclide imaging.182 Cost-effectiveness in this setting is based on both the ability to exclude patients who have cardiac causes of their chest pain and rapid identification of those who are likely to benefit from therapy for acute coronary syndrome.183 MCE represents a more practical approach to perfusion imaging in ED patients because it is able to be performed rapidly at the bedside, it is less expensive than SPECT, and it provides immediate information to the clinician.
Cardiovascular consequences of cocaine use
2015, Trends in Cardiovascular MedicineCitation Excerpt :In such patients, SPECT MPI was able to reliably predict myocardial infarction and/or need for percutaneous intervention and reduce unnecessary admissions [75]. Cost-effectiveness analyses suggest that for patients at intermediate risk of coronary artery disease, SPECT MPI provides a more cost-effective approach, due largely to greater accuracy, than a stress ECG [76]. However, similar studies have not been performed in the context of illicit drug use and whether such extensive testing will be of value in the context of cocaine-associated chest pain is not clear at present.
Structured intercomparison of nuclear medicine physicians' education and training programs in 12 EANM member-affiliated member countries
2014, Medecine NucleaireCitation Excerpt :Their contribution to effective patient care has been widely appreciated, due to their efficiency in the assessment of organ and system function and metabolism. In addition, their proven cost-effectiveness has resulted in a substantial growth in both number and type of procedures [1,2]. In the United States, an increase in the number of NM procedures of approximately 20% has been noticed during the last decade [3].
Copies available from the American Society of Nuclear Cardiology website (www.asnc.org).