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A Call for Randomized Controlled Cost-Effectiveness Analysis of Percutaneous Transluminal Coronary Angioplasty

Published online by Cambridge University Press:  10 March 2009

Norman Holly
Affiliation:
University of Papua New Guinea

Extract

A rapidly evolving technology, percutaneous transluminal coronary angioplasty, is increasingly favored over bypass surgery for treating some types of coronary stenosis because of its less traumatic invasion, better recovery response, and lower initial cost. However, substantially higher failure rates in initial procedures offset PTCA's savings to an unknown extent and cloud analysis of its overall impact. Lack of randomized clinical data precludes valid cost-effectiveness comparison of the technologies at this time. Criteria for establishing valid data and evaluations of currently available data are described in this paper.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1988

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References

REFERENCES

1. Akins, C. W., & Block, P. C.Surgical intervention for failed percutaneous transluminal coronary angioplasty. American Journal of Cardiology, 1984, 53, 108C–11C.CrossRefGoogle ScholarPubMed
2. Barbash, G. I., Rabkin, M. T., Kane, N. M., & Baim, D. S.Coronary angioplasty under the prospective payment system: The need for a severity-adjusted payment scheme. Journal of the American College of Cardiology, 1986, 8, 784–90.CrossRefGoogle ScholarPubMed
3. Bearman, J. et al. Muench's Postulates, Laws and Corollaries. Biometrics Note No. 4, Biometry and Epidemiology Program, National Eye Institute, 04 1974.Google Scholar
4. Bresco, S., Oriol, A., Garcia, J., et al. Coste de la ACTP en un hospital terciario de nuestro medio. Revista Española de Cardiologia, 1985, 38 (Suppl. 1), 7982.Google Scholar
5. Block, P. C.Mechanism of transluminal angioplasty. American Journal of Cardiology, 1984, 52, 69C71C.CrossRefGoogle Scholar
6. Byar, D. P., Simon, R. M., Friedewald, W. T., et al. Randomized clinical trials: Perspectives on some recent ideas. New England Journal of Medicine, 1976, 295, 7480.CrossRefGoogle ScholarPubMed
7. CASS Principal Investigators and Associates. Coronary Artery Surgery Study (CASS):A randomized trial of coronary artery bypass surgery. Survival data. Circulation, 1983, 68, 939–50.CrossRefGoogle Scholar
8. CASS Principal Investigators and Associates. Coronary Artery Surgery Study (CASS): A randomized trial of coronary artery bypass surgery. Quality of life in patients randomly assigned to treatment groups. Circulation, 1983, 68, 951–60.CrossRefGoogle Scholar
9. Cebul, R., & Paulus, R.The failure of intravenous digital subtraction angiography in replacing carotid arteriography. Annals of Internal Medicine, 1986, 104, 572–74.CrossRefGoogle ScholarPubMed
10. Challah, S., & Mays, N.The randomised controlled trial in the evaluation of a new technology: A case study. British Medical Journal, 1986, 191, 877–79.CrossRefGoogle Scholar
11. Chalmers, T. C.Randomization of the first patient. The Medical Clinics of North America, 1975, 59, 1035–38.CrossRefGoogle ScholarPubMed
12. Charles, E. D., Wayne, J. B., Oberman, A., et al. Costs and benefits associated with treatment for coronary artery disease. Circulation, 1982, 66 (Suppl. III), 8790.Google ScholarPubMed
13. Cochrane, A.Effectiveness and efficiency: Random reflections on health services. London: Nuffield Provincial Hospitals Trust, 1972.Google Scholar
14. Cochrane, A. L.Emotion and empiricism (letter). British Medical Journal, 1979, 1, 486.CrossRefGoogle Scholar
15. Communication for the Inspector General of the Department of Health and Human Services to the Prospective Payment Assessment Commission (ProPAC). Technical Appendices to the Report and Recommendations to the Secretary, U.S. Department of Health and Human Services, 04 1, 1985, 109.Google Scholar
16. Cornfield, J.The University Group Diabetes Program–A further statistical analysis of the mortality findings. Journal of the American Medical Association, 1971, 217, 1696–87.Google Scholar
17. Council for Science and Society. Expensive medical technologies: Report of a working party. London, 1982.Google Scholar
18. Cowley, M. J., Dorros, G., Kelsey, S. F., et al. Emergency coronary bypass surgery after coronary angioplasty: The National Heart, Lung, and Blood Institute's Percutaneous Transluminal Coronary Angioplasty Registry experience. American Journal of Cardiology, 1984, 53, 22C26C.CrossRefGoogle ScholarPubMed
19. Department of Clinical Epidemiology and Biostatistics, McMaster University (Canada). How to read clinical journals: VII. To understand an economic evaluation. Canadian Medical Association Journal, 1984, 130, 1428–33 (part A) and 1542–49 (part B).Google Scholar
20. Doll, R.Randomized controlled trials and retrospective controls (letter). British Medical Journal, 1980, 280, 44.CrossRefGoogle Scholar
21. Dotter, C., & Judkins, M.Transluminal treatment of arterioscleric obstruction: Description of a new technique and preliminary report of its application. Circulation, 1964, 30, 654–70.CrossRefGoogle Scholar
22. Drummond, M., Stoddart, G., & Torrance, G.Methods for the evaluation of health care programmes. Oxford: Oxford University Press, 1987.Google Scholar
23. Düber, C., Jungbluth, A., Rumpelt, H-J., et al. Morphology of the coronary arteries after combined thrombolysis and percutaneous transluminal coronary angioplasty for acute myocardial infarction. American Journal of Cardiology, 1986, 58, 698703.CrossRefGoogle ScholarPubMed
24. Dudley, H.The controlled clinical trial and the advance of reliable knowledge: An outsider looks in. British Medical Journal, 1983, 287, 957–60.CrossRefGoogle Scholar
25. Ederer, F.Why do we need controls? Why do we need to randomize? American Journal of Ophthalmology, 1975, 79, 758–62.CrossRefGoogle ScholarPubMed
26. European Coronary Surgery Study Group. Long-term results of prospective randomized study of coronary artery bypass surgery in stable angina pectoris. Lancet, 1982, 2, 1173-80.CrossRefGoogle Scholar
27. European Coronary Surgery Study Group. Prospective randomized study of coronary artery bypass surgery in stable angina pectoris: A progress report on survival. Circulation, 1982, 65 (Suppl. II), 6771.CrossRefGoogle Scholar
28. Favaloro, E.Saphenous vein autograph replacement of severe segmental coronary occlusion: Operative technique. Annals of Thoracic Surgery, 1968, 5, 334–39.CrossRefGoogle Scholar
29. Feeny, D., Guyatt, G., & Tugwell, P.Health care technology: Effectiveness, efficiency, and public policy. Montreal: L'lnstitut de recherches politiques, 1986.Google Scholar
30. Fisher, R. A.The arrangement of field experiments. Journal of Mining and Agriculture in Great Britain, 1926, 33, 503–13.Google Scholar
31. Gaspard, Ph., et al. Effets a long terme de l'angioplastie coronaire transluminale: Étude multicentrique française. Archives de Maladies du Coeur et des Vaisseaux, 1985, 78, 167–73.Google Scholar
32. Gruentzig, A., et al. Eine neue methode zur perkutanen dilation von koronarstenosen– Tierexperimentelle prüfung. Verhandlungen der Deutschen Geseilsehaft für Kreislaufforschung, 1976, 42, 282–85.CrossRefGoogle Scholar
33. Gruentzig, A., Myler, R., Hanna, E., & Turina, M.Transluminary angioplasty of coronary artery stenosis. Circulation, 1977, 56 (Suppl. III), 84. Abstract.Google Scholar
34. Gruentzig, A., Senning, A., & Siegenthaler, W.Nonoperative dilation of coronary artery stenosis. New England Journal of Medicine, 1979, 301, 6168.CrossRefGoogle Scholar
35. Gruentzig, A.Percutaneous transluminal coronary angioplasty: Six years' experience. American Heart Journal, 1984, 107, 818–19.CrossRefGoogle ScholarPubMed
36. Grupo de trabajo de la Comisión asesora de alta technologia médica de la Dirección General de Planificación y Ordenación Sanitaria. ACTP. Informe especial para la Conselleria de Sanitat de Catalunya: indicaciones, demanda, estado actual de técnica, acreditación, productividad e implicaciones organizativas y costos. Revista Española de Cardiologia, 1985, 38 (Suppl. 1), 713.Google Scholar
37. Guyatt, G., Drummond, M., Feeny, D., et al. Guidelines for the clinical and economic evaluation of health care technologies. Social Science and Medicine, 1986, 22, 393408.CrossRefGoogle ScholarPubMed
38. Guyatt, G., Tugwell, P. X., Feeny, D. H., et al. The role of before-after studies of therapeutic impact in the evaluation of diagnostic technologies. Journal of Chronic Diseases, 1986, 39, 295304.CrossRefGoogle ScholarPubMed
39. Health Council of Catelonia, General Directorate of Health Planning and Organization. ACTP. Informe especial para le Conselleria de Sanitat de Catalunya: Indicaciones, demanda, estado actual de Ia tecnica, acreditación, productividad e implicaciones organizativas y costos. Revista Espanola de Cardiologia, 1985, 38 (Suppl.), 713.Google Scholar
40. Hellinger, F. J.An analysis of public programs for heart transplantation. Journal of Human Resources, 1982, 7, 307–13.CrossRefGoogle Scholar
41. Holmes, D. Jr, & Vlietstra, R.Percutaneous transluminal coronary angioplasty: Current status and future trends. Mayo Clinic Proceedings, 1986, 61, 865–76.CrossRefGoogle ScholarPubMed
42. Ilsley, C., Wilkins, G., Amarasingham, R., et al. Percutaneous transluminal coronary angioplasty: The early Dunedin experience. New Zealand Medical Journal, 1985, 98, 4749.Google ScholarPubMed
43. Jang, G., Baskerville, A. L., Willis, W. H., & Jacobson, J. G.Cost analysis and eligibility assessment of the transluminal coronary angioplasty. Circulation, 1981, 64 (Suppl. IV), IV90. Abstract.Google Scholar
44. Jang, G., Gruentzig, A. R., Block, P. C., et al. Comparative cost analysis of coronary angioplasty and coronary bypass surgery: Results from a national cooperative study. Circulation, 1982, 66 (Suppl. II), 11123.Google Scholar
45. Jang, G. C., Block, P. C., Cowley, M. J., et al. Relative cost of coronary angioplasty and bypass surgery in a one-vessel disease model. American Journal of Cardiology, 1984, 53, 52C55C.CrossRefGoogle Scholar
46. Jennett, B.High technology medicine: benefits and burdens. Oxford: Oxford University Press, 1986.Google Scholar
47. Kaltenbach, M., Greuntzig, A., Rentrop, K., & Bussman, W. (eds.) Transluminal coronary angioplasty and inercoronary thrombosis coronary heart disease IV Berlin: Springer Verlag, 1982.CrossRefGoogle Scholar
48. Kaltenbach, M., Kober, G., Scherer, D., & Vallbracht, C.Rezidivhaufigkeit nach erforgreicher ballondilation von Kranzarterienstenosen. Kardiologie, 1984, 73 (Suppl. 2), 161–65.Google Scholar
49. Kaltenbach, M.Positiv langzeitresultate der transluminalen koronarangioplastik. Kardiologie, 1985, 103, 355–57.Google Scholar
50. Kelly, M., Taylor, G. J., Moses, H. W., et al. Comparative cost of myocardial revascularization: percutaneous transluminal angioplasty and coronary artery bypass surgery. Journal of the American College of Cardiology, 1985, 5, 1620.CrossRefGoogle ScholarPubMed
51. Kempthorne, O.Why randomize? Journal of Statistical Planning and Inference, 1977, 1, 125.CrossRefGoogle Scholar
52. Killip, T., & Ryan, T.Randomized trials in coronary bypass surgery. Circulation, 1985, 71, 418–21.CrossRefGoogle ScholarPubMed
53. King, S., Director, Interventional Cardiology, Emory University. Personal communication, 01 30, 1987.Google Scholar
54. Kober, G., et al. Transluminale koronare Angioplastik 1977–1985: Erfahrungen bei 1000 eingriffen. Radiologe, 1985, 25, 346–53.Google Scholar
55. Kornfeld, D. S., Heller, S. S., Frank, K. A., et al. Psychological and behavioral responses after coronary artery bypass surgery. Circulation, 1982, 66 (Suppl. III), 2428.Google ScholarPubMed
56. Mckinlay, J. B. From “promising report” to “standard procedure”: Seven stages in the career of a medical innovation. In McKinlay, J. B. (ed.), Technology and the future of health care, Milbank Reader 8. Cambridge, MA: The MIT Press, 1982, 233–70.Google Scholar
57. Mock, M. B., Ringqvist, I., Fisher, L. D., et al. Survival of medically treated patients in the Coronary Artery Surgery Study (CASS) registry. Circulation, 1982, 66, 562–68.CrossRefGoogle ScholarPubMed
58. Murphy, D. A., Craver, J. M., Jones, E. L., et al. Surgical revascularization following unsuccessful percutaneous transluminal coronary angioplasty. Journal of Thoracic Cardiovascular Surgery, 1982, 84, 342–48.CrossRefGoogle ScholarPubMed
59. National Academy of Sciences, Institute of Medicine. Assessing medical technologies. Washington: National Academy Press, 1985.Google Scholar
60. Oldham, P. D.Measurement in medicine: The interpretation of numerical data. Philadelphia: Lippincott, 1968.Google Scholar
61. Peto, R., Pike, M. C., Armitage, P., et al. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. 1. Introduction and design. British Journal of Cancer, 1976, 34, 585612. II. Analysis and examples. British Journal of Cancer, 1977, 35, 1–39.CrossRefGoogle Scholar
62. Prospective Payment Assessment Commission. Technical appendices to the Report and Recommendations to the Secretary, U.S. Department of Health and Human Services, 04 1, 1985, 108.Google Scholar
63. Rapaport, E.An overview of the issues. Circulation, 1982, 66 (Suppl. III), 35.Google Scholar
64. Reeder, G., Krishan, I., Nobrega, F. T., et al.Is percutaneous coronary angioplasty less expensive than bypass surgery? New England Journal of Medicine, 1984, 311, 1157–62.CrossRefGoogle ScholarPubMed
65. Reul, .G, et al.Cogronary artery bypass for unsuccessful percutaneous transluminal coronary angioplasty. Journal of Thoracic Cardiovascular Surgery, 1984, 88, 685–94.CrossRefGoogle ScholarPubMed
66. Ringqvist, I., et al. Prognostic value of angiographic indices of coronary artery disease from the Coronary Artery Surgery Study (CASS). Journal of Clinical Investigation, 1983, 71, 1854–66.CrossRefGoogle ScholarPubMed
67. Robertson, T. L., Chief, Cardiac Disease Branch and Director of the PTCA Registry, U.S. National Heart, Lung, and Blood Institute. Personal communication, 02 2, 1987.Google Scholar
68. Sackett, D. L.Bias in analytic research. Journal of Chronic Diseases, 1979, 32, 5163.CrossRefGoogle ScholarPubMed
69. Spodick, D. H.The surgical mystique and the double standard. American Heart Journal, 1973, 85, 579–83.CrossRefGoogle ScholarPubMed
70. Stemmer, E. Discussion of Wilson, J., et al. (see reference 14). Journal of Thoracic Cardiovascular Surgery, 1986, 91, 369–70.Google Scholar
71. Stiles, Q., Ullyot, D., & Stemmer, E. Discussion of Wilson, J., et al. (see Reference 14). Journal of Thoracic Cardiovascular Surgery, 1986, 91, 368–69.Google Scholar
72. Takaro, T., Hultgren, H. N., Detre, K. M., & Peduzzi, P.The Veterans Administration Cooperative Study of stable angina: Current status. Circulation, 1982, 65 (Suppl. II), 60.CrossRefGoogle ScholarPubMed
73. Tomas, Abadal L., & BalaguerVintro, I. Vintro, I.Aspectos epidemiologicos de la ACTP: Como plantear un estudio prospectivo. Revista Espanola de Cardiologia, 1985, 38 (Suppl. 1), 6578.Google Scholar
74. U.S. Public Health Service, National Center for Health Services Research and Health Care Technology Assessment. Patient selection criteria for percutaneous translumina! coronary angioplasty. Health Technology Assessment Reports Number 11, 1985.Google Scholar
75. Warner, K., & Luce, B.Cost-benefit and cost-effectiveness analysis in health care. Ann Arbor: University of Michigan Health Administration Press, 1982.Google ScholarPubMed
76. Weinstein, M., & Stason, W.Cost-effectiveness of coronary bypass surgery. Circulation, 1982, 66 (Suppl. III), 5666.Google Scholar
77. Williams, A.Economics of coronary artery bypass grafting. British Medical Journal, 1985, 291, 326–29.CrossRefGoogle ScholarPubMed
78. Wilson, J. M., et al. The cost of simultaneous surgical standby for percutaneous transluminal coronary angioplasty. Journal of Thoracic Cardiovascular Surgery, 1986, 91, 362–70.CrossRefGoogle ScholarPubMed
79. World Health Organization and International Society and Federation of Cardiology. Report of the Task Force on Coronary Angiograms and Coronary Interventions, Geneva, April 21–22, 1986. Circulation, 1986, 75, 895A–97A.Google Scholar