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Cost-Effectiveness Analysis of Natriuretic Peptide Testing and Specialist Management in Patients with Suspected Acute Heart Failure

Overview of attention for article published in Value in Health (Elsevier Science), July 2017
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Title
Cost-Effectiveness Analysis of Natriuretic Peptide Testing and Specialist Management in Patients with Suspected Acute Heart Failure
Published in
Value in Health (Elsevier Science), July 2017
DOI 10.1016/j.jval.2017.05.007
Pubmed ID
Authors

Edward A. Griffin, David Wonderling, Andrew J. Ludman, Abdallah Al-Mohammad, Martin R. Cowie, Suzanna M.C. Hardman, John J.V. McMurray, Jason Kendall, Polly Mitchell, Aminat Shote, Katharina Dworzynski, Jonathan Mant

Abstract

To determine the cost-effectiveness of natriuretic peptide (NP) testing and specialist outreach in patients with acute heart failure (AHF) residing off the cardiology ward. We used a Markov model to estimate costs and quality-adjusted life-years (QALYs) for patients presenting to hospital with suspected AHF. We examined diagnostic workup with and without the NP test in suspected new cases, and we examined the impact of specialist heart failure outreach in all suspected cases. Inputs for the model were derived from systematic reviews, the UK national heart failure audit, randomized controlled trials, expert consensus from a National Institute for Health and Care Excellence guideline development group, and a national online survey. The main benefit from specialist care (cardiology ward and specialist outreach) was the increased likelihood of discharge on disease-modifying drugs for people with left ventricular systolic dysfunction, which improve mortality and reduce re-admissions due to worsened heart failure (associated with lower utility). Costs included diagnostic investigations, admissions, pharmacological therapy, and follow-up heart failure care. NP testing and specialist outreach are both higher cost, higher QALY, cost-effective strategies (incremental cost-effectiveness ratios of £11,656 and £2,883 per QALY gained, respectively). Combining NP and specialist outreach is the most cost-effective strategy. This result was robust to both univariate deterministic and probabilistic sensitivity analyses. NP testing for the diagnostic workup of new suspected AHF is cost-effective. The use of specialist heart failure outreach for inpatients with AHF residing off the cardiology ward is cost-effective. Both interventions will help improve outcomes for this high-risk group.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 69 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 69 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 9 13%
Student > Master 9 13%
Student > Ph. D. Student 8 12%
Student > Bachelor 5 7%
Other 4 6%
Other 10 14%
Unknown 24 35%
Readers by discipline Count As %
Medicine and Dentistry 15 22%
Nursing and Health Professions 8 12%
Economics, Econometrics and Finance 3 4%
Social Sciences 3 4%
Agricultural and Biological Sciences 2 3%
Other 10 14%
Unknown 28 41%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 July 2017.
All research outputs
#20,660,571
of 25,382,440 outputs
Outputs from Value in Health (Elsevier Science)
#2,972
of 4,140 outputs
Outputs of similar age
#250,883
of 324,855 outputs
Outputs of similar age from Value in Health (Elsevier Science)
#40
of 57 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. This one is in the 10th percentile – i.e., 10% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,140 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one is in the 13th percentile – i.e., 13% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 324,855 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 12th percentile – i.e., 12% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 57 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.