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dc.contributor.authorReeves, P
dc.contributor.authorEdmunds, K
dc.contributor.authorLevi, C
dc.contributor.authorLin, L
dc.contributor.authorCheng, X
dc.contributor.authorAviv, R
dc.contributor.authorKleinig, T
dc.contributor.authorButcher, K
dc.contributor.authorZhang, J
dc.contributor.authorParsons, M
dc.contributor.authorBivard, A
dc.date.accessioned2021-04-21T03:49:33Z
dc.date.available2021-04-21T03:49:33Z
dc.date.issued2018
dc.identifier.issn1932-6203en_US
dc.identifier.doi10.1371/journal.pone.0206203en_US
dc.identifier.urihttp://hdl.handle.net/10072/403872
dc.description.abstractIntroduction The use of multimodal computed tomography imaging (MMCT) in routine clinical assessment of stroke patients improves the identification of patients with large regions of salvageable brain tissue, lower risk for haemorrhagic transformation, or a large vessel occlusion requiring endovascular therapy. Aim To evaluate the cost-effectiveness of using MMCT compared to usual practice for determining eligibility for reperfusion therapy with alteplase using real world data from the International Stroke Perfusion Imaging Registry (INSPIRE). Methods We performed a cost-utility analysis. Mean costs and quality-adjusted life years (QALYs) per patient for two alternative screening protocols were calculated. Protocol 1 represented usual practice, while Protocol 2 reflected treatment targeting using multimodal imaging. Cost-effectiveness was assessed using the net-benefit framework. Results Protocol 1 had a total mean per patient cost of $2, 013 USD and 0.148 QALYs. Protocol 2 had a total mean per patient cost of $1, 519 USD and 0.153 QALYs. For a range of willingness- to-pay values, representing implicit thresholds of cost-effectiveness, the lower bound of the incremental net monetary benefit statistic was consistently greater than zero, indicating that MMCT is cost- effective compared to usual practice. The results were most sensitive to variation in the mean number of alteplase vials administered. Conclusion In a healthcare setting where multimodal imaging technologies are available and reimbursed, their use in screening patients presenting with acute stroke to determine eligibility for alteplase treatment is cost-effective given a range of willingness-to-pay thresholds and warrants consideration as an alternative to routine practice. Copyright:en_US
dc.description.peerreviewedYesen_US
dc.languageengen_US
dc.publisherPublic Library of Science (PLoS)en_US
dc.relation.ispartofpagefrome0206203en_US
dc.relation.ispartofissue10en_US
dc.relation.ispartofjournalPLoS Oneen_US
dc.relation.ispartofvolume13en_US
dc.subject.fieldofresearchClinical Sciencesen_US
dc.subject.fieldofresearchcode1103en_US
dc.titleCost-effectiveness of targeted thrombolytic therapy for stroke patients using multi-modal CT compared to usual practiceen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationReeves, P; Edmunds, K; Levi, C; Lin, L; Cheng, X; Aviv, R; Kleinig, T; Butcher, K; Zhang, J; Parsons, M; Bivard, A, Cost-effectiveness of targeted thrombolytic therapy for stroke patients using multi-modal CT compared to usual practice, PLoS One, 2018, 13 (10), pp. e0206203en_US
dcterms.dateAccepted2018-10-09
dcterms.licensehttps://creativecommons.org/licenses/by/4.0/en_US
dc.date.updated2021-04-20T22:47:47Z
dc.description.versionVersion of Record (VoR)en_US
gro.rights.copyright© 2018 Reeves et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_US
gro.hasfulltextFull Text
gro.griffith.authorEdmunds, Kim


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