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首页> 外文期刊>European heart journal cardiovascular Imaging >Systematic review of cost-effectiveness of myocardial perfusion scintigraphy in patients with ischaemic heart disease
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Systematic review of cost-effectiveness of myocardial perfusion scintigraphy in patients with ischaemic heart disease

机译：缺血性心脏病患者心肌灌注闪烁闪烁成本效果的系统综述

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摘要

Coronary artery disease (CAD) is a major cause of death and disability. Several diagnostic tests, such as myocardial perfusion scintigraphy (MPS), are accurate for the detection of CAD, as well as having prognostic value for the prediction of cardiovascular events. Nevertheless, the diagnostic and prognostic value of these tests should be cost-effective and should lead to improved clinical outcome. We have reviewed the literature on the cost-effectiveness of MPS in different circumstances: (i) the diagnosis and management of CAD; (ii) comparison with exercise electrocardiography (ECG) and other imaging tests; (iii) as gatekeeper to invasive coronary angiography (ICA), (iv) the impact of appropriate use criteria; (v) acute chest pain, and (vi) screening of asymptomatic patients with type-2 diabetes. In total 57 reports were included. Although most non-invasive imaging tests are cost-effective compared with alternatives, the data conflict on which non-invasive strategy is the most cost-effective. Different definitions of cost-effectiveness further confound the subject. Computer simulations of clinical diagnosis and management are influenced by the assumptions made. For instance, diagnostic accuracy is often defined against an anatomical standard that is wrongly assumed to be perfect. Conflicting data arise most commonly from these incorrect or differing assumptions.
机译：冠状动脉疾病（CAD）是死亡和残疾的主要原因。若干诊断测试，例如心肌灌注闪烁（MPS），对于CAD的检测是准确的，以及具有预测心血管事件的预后值。然而，这些测试的诊断和预后价值应具有成本效益，并应导致临床结果改善。我们在不同情况下审查了MPS成本效益的文献：（i）CAD的诊断和管理; （ii）与运动心电图（ECG）和其他成像测试的比较; （iii）作为侵入性冠状动脉造影（ICA），（iv）适当使用标准的影响; （v）急性胸部疼痛，（vi）筛选患有2型糖尿病的无症状患者。总共包括57个报告。尽管大多数非侵入性成像测试与替代方案相比具有成本效益，但无侵入策略是最具成本效益的数据冲突。成本效益的不同定义进一步混淆了这个问题。临床诊断和管理的计算机模拟受假设的影响。例如，诊断准确性通常根据错误认为是完美的解剖标准来定义。冲突的数据来自这些不正确或不同的假设。

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    Tragardh Elin; Tan Siok Swan; Bucerius Jan; Gimelli Alessia; Gaemperli Oliver; Lindner Oliver; Agostini Denis; Uebleis Christopher; Sciagra Roberto; Slart Riemer H.; Underwood S. Richard; Hyafil Fabien; Hacker Marcus; Verberne Hein J.;

  • 作者单位

    Lund Univ Clin Physiol &

    Nucl Med Inga Marie Nilssons Gata 49 S-20502 Malmo Sweden;

    Erasmus Univ Inst Med Technol Assessment Burgemeester Oudlaan 50 NL-3062 PA Rotterdam;

    Maastricht Univ Med Ctr Dept Nucl Med POB 5800 NL-6202 AZ Maastricht Netherlands;

    Fdn Toscana Gabriele Monasterio Via Guiseppe Moruzzi 1 I-56124 Pisa Italy;

    Univ Heart Ctr Cardiac Imaging &

    Intervent Cardiol Ramistr 100 CH-8091 Zurich Switzerland;

    Ruhr Univ Bochum Univ Hosp Inst Radiol Nucl Med &

    Mol Imaging Heart &

    Diabet Ctr North Rhine;

    Univ Hosp Caen Dept Nucl Med Ave Cote Nacre F-104009 Caen 1 France;

    Ludwig Maximilians Univ Munchen Dept Clin Radiol Marchioninistr 15 D-81377 Munich Germany;

    Univ Florence Dept Expt &

    Clin Biomed Sci Nucl Med Unit Largo Brambilla 3 I-50134 Florence;

    Univ Groningen Univ Med Ctr Groningen Dept Nucl Med &

    Mol Imaging POB 30001 NL-9700 RB;

    Royal Brompton Hosp Imperial Coll London Natl Heart &

    Lung Inst Sydney St London SW3 6NP;

    Univ Paris Diderot Inserm 1148 DHU FIRE Dept Nucl Med Bichat Univ Hosp 46 Rue Henri Huchard F;

    Med Univ Vienna Dept Biomed Imaging &

    Image Guided Therapy Div Nucl Med Wahringer Gurtel 18-20;

    Univ Amsterdam Acad Med Ctr Dept Nucl Med Meibergdreef 9 NL-1105 AZ Amsterdam Netherlands;

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  • 正文语种 eng
  • 中图分类 内科学;
  • 关键词

    cost effectiveness; myocardial perfusion scintigraphy; ischaemic heart disease;

    机译：成本效益;心肌灌注闪烁图;缺血性心脏病;

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