Evidence map›Paper›PMID 38128500›Full record

ArticleNeuroepidemiology2024

Endovascular Thrombectomy with or without Bridging Thrombolysis in Acute Ischemic Stroke: A Cost-Effectiveness Analysis.

Rami Z Morsi, Yuan Zhang, Meng Zhu, Shitong Xie, Julián Carrión-Penagos, Harsh Desai, Elie Tannous, Sachin A Kothari, Assem Khamis, Andrea J Darzi and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuroepidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Costs of Neurological Disorders.Neuroepidemiology · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Rami Z MorsiDepartment of Neurology, University of Chicago, Chicago, Illinois, USA, ramimorsi93@gmail.com.
Yuan ZhangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Meng ZhuDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Shitong XieSchool of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
Julián Carrión-PenagosDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Harsh DesaiDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Elie TannousDepartment of Pathology, Albany Medical Center, Albany, New York, USA.
Sachin A KothariDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Assem KhamisWolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.
Andrea J DarziDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Ammar TarabichiDENT Neuroimaging Center, DENT Neurologic Institute, Amherst, New York, USA.
Reena BastinDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Layal HneinyWegner Health Sciences Information Center, University of South Dakota, Sioux Falls, South Dakota, USA.
Sonam ThindDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
James E SieglerDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Elisheva R ColemanDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Scott J MendelsonDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Ali MansourDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Shyam PrabhakaranDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.
Tareq Kass-HoutDepartment of Neurology, University of Chicago, Chicago, Illinois, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is unclear added benefit of intravenous thrombolysis (IVT) with endovascular thrombectomy (EVT). We performed a cost-effectiveness analysis to assess the cost-effectiveness of comparing EVT with IVT versus EVT alone.

methodsWe used a decision tree to examine the short-term costs and outcomes at 90 days after the occurrence of index stroke to compare the cost-effectiveness of EVT alone with EVT plus IVT for patients with stroke. Subsequently, we developed a Markov state transition model to assess the costs and outcomes over 1-year, 5-year, and 20-year time horizons. We estimated total and incremental cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio.

resultsThe average costs per patient were estimated to be $47,304, $49,510, $59,770, and $76,561 for EVT-only strategy and $55,482, $57,751, $68,314, and $85,611 for EVT with IVT over 90 days, 1 year, 5 years, and 20 years, respectively. The cost saving of EVT-only strategy was driven by the avoided medication costs of IVT (ranging from $8,178 to $9,050). The additional IVT led to a slight decrease in QALY estimate during the 90-day time horizon (loss of 0.002 QALY), but a small gain over 1-year and 5-year time horizons (0.011 and 0.0636 QALY). At a willingness-to-pay threshold of $50,000 per QALY gained, the probabilities of EVT only being cost-effective were 100%, 100%, and 99.3% over 90-day, 1-year, and 5-year time horizons.

conclusionOur cost-effectiveness model suggested that EVT only may be cost-effective for patients with acute ischemic stroke secondary to large vessel occlusion.

Indexed as

Brain IschemiaEndovascular ProceduresIschemic StrokeStrokeCost-Benefit AnalysisCost-Effectiveness AnalysisHumansThrombectomyThrombolytic TherapyTreatment OutcomeCostCost-effectivenessStrokeThrombectomyThrombolytic

Identifiers

PMID38128500
PMCPMC10857025

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.