Elsevier

Journal of Nuclear Cardiology

Volume 12, Issue 6, November–December 2005, Pages 750-759
Journal of Nuclear Cardiology

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Cost-effectiveness of myocardial perfusion imaging: A summary of the currently available literature

https://doi.org/10.1016/j.nuclcard.2005.10.001Get rights and content

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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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