PMID- 21557632
OWN - NLM
STAT- MEDLINE
DCOM- 20111212
LR  - 20211020
IS  - 1179-2027 (Electronic)
IS  - 1170-7690 (Linking)
VI  - 29
IP  - 9
DP  - 2011 Sep
TI  - Decision-analytic models to simulate health outcomes and costs in heart failure: 
      a systematic review.
PG  - 753-69
LID - 10.2165/11585990-000000000-00000 [doi]
AB  - Chronic heart failure (CHF) is a critical public health issue with increasing 
      effect on the healthcare budgets of developed countries. Various 
      decision-analytic modelling approaches exist to estimate the cost effectiveness 
      of health technologies for CHF. We sought to systematically identify these models 
      and describe their structures. We performed a systematic literature review in 
      MEDLINE/PreMEDLINE, EMBASE, EconLit and the Cost-Effectiveness Analysis Registry 
      using a combination of search terms for CHF and decision-analytic models. The 
      inclusion criterion required 'use of a mathematical model evaluating both costs 
      and health consequences for CHF management strategies'. Studies that were only 
      economic evaluations alongside a clinical trial or that were purely descriptive 
      studies were excluded. We identified 34 modelling studies investigating different 
      interventions including screening (n = 1), diagnostics (n = 1), pharmaceuticals 
      (n = 15), devices (n = 13), disease management programmes (n = 3) and cardiac 
      transplantation (n = 1) in CHF. The identified models primarily focused on 
      middle-aged to elderly patients with stable but progressed heart failure with 
      systolic left ventricular dysfunction. Modelling approaches varied substantially 
      and included 27 Markov models, three discrete-event simulation models and four 
      mathematical equation sets models; 19 studies reported QALYs. Three models were 
      externally validated. In addition to a detailed description of study 
      characteristics, the model structure and output, the manuscript also contains a 
      synthesis and critical appraisal for each of the modelling approaches. Well 
      designed decision models are available for the evaluation of different CHF health 
      technologies. Most models depend on New York Heart Association (NYHA) classes or 
      number of hospitalizations as proxy for disease severity and progression. As the 
      diagnostics and biomarkers evolve, there is the hope for better intermediate 
      endpoints for modelling disease progression as those that are currently in use 
      all have limitations.
FAU - Goehler, Alexander
AU  - Goehler A
AD  - Institute for Technology Assessment and Department of Radiology, Massachusetts 
      General Hospital, Harvard Medical School, Boston, Massachusetts 02214, USA. 
      alex@mgh-ita.org
FAU - Geisler, Benjamin P
AU  - Geisler BP
FAU - Manne, Jennifer M
AU  - Manne JM
FAU - Jahn, Beate
AU  - Jahn B
FAU - Conrads-Frank, Annette
AU  - Conrads-Frank A
FAU - Schnell-Inderst, Petra
AU  - Schnell-Inderst P
FAU - Gazelle, G Scott
AU  - Gazelle GS
FAU - Siebert, Uwe
AU  - Siebert U
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
PL  - New Zealand
TA  - Pharmacoeconomics
JT  - PharmacoEconomics
JID - 9212404
MH  - Cost-Benefit Analysis
MH  - *Decision Support Techniques
MH  - Disease Progression
MH  - Heart Failure/*economics/physiopathology/therapy
MH  - Humans
MH  - Models, Statistical
MH  - *Models, Theoretical
MH  - Quality-Adjusted Life Years
MH  - Severity of Illness Index
EDAT- 2011/05/12 06:00
MHDA- 2011/12/14 06:00
CRDT- 2011/05/12 06:00
PHST- 2011/05/12 06:00 [entrez]
PHST- 2011/05/12 06:00 [pubmed]
PHST- 2011/12/14 06:00 [medline]
AID - 10.2165/11585990-000000000-00000 [doi]
PST - ppublish
SO  - Pharmacoeconomics. 2011 Sep;29(9):753-69. doi: 10.2165/11585990-000000000-00000.