NDLI: Análisis de coste-utilidad del manejo de la fibrilación auricular concomitante en España.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	López Gude, María Jesús Rodríguez Bezos, Desiré Rodríguez Barrios, José Manuel
Spatial Coverage	Spain
Description	Author Affiliation: López Gude MJ ( Servicio de Cirugía Cardiaca, Hospital 12 de Octubre, Madrid, España.)
Abstract	OBJECTIVES: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice; this disorder is a risk factor for stroke and is associated with substantial morbidity and mortality. Our objective was to develop a cost-utility analysis of the different treatment alternatives in patients aged 40 years old or more with concomitant AF with valve disease in Spain, from the National Health System perspective. METHODS: An economic evaluation through a Markov model with four health states (sinus rhythm, AF, dependent stroke, death) was developed to simulate the evolution of a cohort of 1,000 patients receiving each treatment alternative in addition to mitral valve surgery (drug therapy, surgical ablation and catheter ablation). The time horizon was 5 years, with a cycle length of 3 months. Data on costs and effects were obtained from the published literature and expert opinion and were discounted at 3.5%. A sensitivity analysis was developed to determine the robustness of the results. RESULTS: The quality-adjusted life years (QALY) gained were 3.29, 3.89, and 3.83, respectively, for the alternatives of no ablation, surgical ablation and catheter ablation. The costs per patient were 5,770euro, 10,034euro and 11,289euro, respectively. The surgical ablation cost/QALY rate compared with no ablation was 7,145euro. Surgical ablation was dominant versus catheter ablation. The probabilistic sensitivity analysis showed that the results were robust. CONCLUSIONS: Surgical ablation is a cost-effective treatment option in patients with concomitant AF, with a cost-effectiveness ratio under the efficiency threshold commonly accepted in Spain.
Related Links	http://www.scielosp.org/scielo.php?script=sci_arttext&nrm=iso&lng=pt&tlng=pt&pid=S0213-91112010000100010
File Format	HTM / HTML
ISSN	02139111
Issue Number	1
Volume Number	24
e-ISSN	15781283
Journal	Gaceta Sanitaria
Language	Spanish
Publisher	Elsevier
Publisher Date	2010-01-01
Publisher Place	Spain
Access Restriction	Subscribed
Subject Keyword	Discipline Public Health Anti-arrhythmia Agents Economics Atrial Fibrillation Cardiac Surgical Procedures Aged Aged, 80 And Over Therapeutic Use Drug Therapy Epidemiology Etiology Surgery Methods Catheter Ablation Cost-benefit Analysis Female Heart Valve Prosthesis Humans Male Markov Chains Middle Aged Mitral Valve Insufficiency Complications Models, Theoretical Monte Carlo Method National Health Programs Quality-adjusted Life Years Spain Comparative Study English Abstract Journal Article
Alternative Title	Cost-benefit analysis of concomitant atrial fibrillation management in Spain
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in