Echocardiography in newly diagnosed atrial fibrillation patients: a systematic review and economic evaluation
Simpson, EL, Stevenson, MD, Scope, A, Poku, E, Minton, J, Evans P
Record ID 32010000316
English
Authors' objectives:
The assessment investigated the clinical effectiveness and cost-effectiveness of performing routine TTE in all newly diagnosed patients with AF, in comparison with the current practice of selective testing.
Authors' recommendations:
Transthoracic echocardiography is a non-invasive procedure with the potential to accurately identify treatable pathologies in patients with AF.Where the CHADS2 tool is used, the addition of TTE in identifying patients with left atrial abnormality appears to be cost-effective for informing some oral anticoagulation decisions. A simple analysis indicates that the QALYs required for TTE to be cost-effective is small, and that if benefits beyond those associated with a reduction in stroke (at the expense of greater number of bleed) are believed probable then TTE is likely to be cost-effective in all scenarios.Our findings suggest that further research is needed to follow-up newly diagnosed patients with AF who have undergone TTE, to study treatments given as a result of TTE diagnoses and subsequent cardiovascular events, which could identify additional benefits of routine testing, beyond stroke prevention. Studies assessing the proportion of people with a CHADS2 scores of 0 or 1 that have left atrial abnormality would provide better estimates of the cost-effectiveness of TTE, and allow more accurate estimates of the sensitivity and specificity of TTE for identifying left atrial abnormality in AF to be obtained.
Details
Project Status:
Completed
Year Published:
2013
URL for published report:
http://www.hta.ac.uk/2175
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Atrial Fibrillation
Contact
Organisation Name:
NIHR Health Technology Assessment programme
Contact Address:
NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
journals.library@nihr.ac.uk
Contact Email:
journals.library@nihr.ac.uk
Copyright:
<p>2013 Queen's Printer and Controller of HMSO</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.