Abstract：
:In our increasingly cost-conscious health system, patients, clinicians, hospitals, and payers all agree about the urgent need to rein in runaway healthcare costs. High pharmaceutical costs make drugs unaffordable to many patients who may benefit from them, including some insured patients who face prohibitive out-of-pocket costs. Health systems and payers can use the systematic framework of cost-effectiveness analysis and estimated budgetary impact to prioritize the adoption of new therapies and technologies. In this review article, we discuss basic principles of cost-effectiveness research for practicing clinicians, the concept of cost-effectiveness versus affordability, other considerations relevant to resource allocation, and limitations of cost-effectiveness research. We use the example of lipid lowering therapies to discuss application of cost-effectiveness research in informing health care policy, its use for health care systems and in the development of clinical practice guidelines, and its implications for clinicians and patients. As clinicians and patients become more cognizant of the cost-implications of new therapies, professional societies can help improve the quality of decision-making by incorporating unbiased value statements into their expert guidelines.
journal_name
Prog Cardiovasc Disjournal_title
Progress in cardiovascular diseasesauthors
Kazi DS,Virani SSdoi
10.1016/j.pcad.2019.10.006subject
Has Abstractpub_date
2019-01-01 00:00:00pages
406-413issue
5eissn
0033-0620issn
1873-1740pii
S0033-0620(19)30131-8journal_volume
62pub_type
杂志文章,评审abstract：:Massive pulmonary embolism carries a high mortality rate as a result of right ventricular failure. In addition to anticoagulation, systemic thrombolysis is the standard first line of therapy for patients with life-threatening massive pulmonary embolism. Surgical embolectomy is often considered in patients with contrai...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2010.01.002
更新日期：2010-03-01 00:00:00
abstract：:First isolated in the early 1960s, doxorubicin (DOX) remains among the most effective anticancer drug ever developed. However, this drug has proven to be a double-edged sword because it also causes a cardiomyopathy that leads to a form of congestive heart failure that is usually refractory to common medications. It is...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2006.10.002
更新日期：2007-03-01 00:00:00
abstract：:Historically, risk stratification for survivors of acute myocardial infarction (AMI) has centered on 3 principles: assessment of left ventricular function, detection of residual myocardial ischemia, and estimation of the risk for sudden cardiac death. Although these factors still have important prognostic implications...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.2000.0420273
更新日期：2000-01-01 00:00:00
abstract：:The sympathetic nervous system occupies a prominent role in heart failure both as a marker of severity of disease and also as an important factor in its progression. Beta blocker therapy, once thought heretical in heart failure, has consistently improved cardiac function and slowed progression of disease. Large clinic...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.1999.0410301
更新日期：1999-01-01 00:00:00
abstract：:The QT Variability Index (QTVI) is a non-invasive measure of repolarization lability that has been applied to a wide variety of subjects with cardiovascular disease. It is a ratio of normalized QT variability to normalized heart rate variability, and therefore includes an assessment of autonomic nervous system tone. T...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2013.07.004
更新日期：2013-09-01 00:00:00
abstract：:Several randomized trials and meta-analyses have shown that primary angioplasty is superior to thrombolysis in the treatment of ST-segment elevation myocardial infarction (MI) in terms of death, reinfarction, and stroke. However, primary angioplasty should be regarded as the preferred strategy as long as it can not be...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2007.11.004
更新日期：2008-03-01 00:00:00
abstract：:Echocardiography is a valuable technique for the diagnosis and serial follow-up of patients with impaired cardiac function. It is subject to certain limitations due to the assumptions inherent in deriving ventricular volume from a one-dimensional measurement and must be interpreted with caution in cases of suspected r...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/0033-0620(78)90018-x
更新日期：1978-09-01 00:00:00
abstract：:Cardiovascular diseases (CVDs) are the leading cause of death and disability in India. Moreover, mortality following an acute myocardial infarction is high, which may be due to gaps in secondary prevention in general and a lack of cardiac rehabilitation (CR) services in particular. This review discusses the availabili...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2013.11.001
更新日期：2014-03-01 00:00:00
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journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2013.05.007
更新日期：2013-07-01 00:00:00
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journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2017.10.005
更新日期：2017-01-01 00:00:00
abstract：:Cardiac imaging plays an important role in coronary artery disease (CAD), congestive heart failure (HF) and valvular heart disease (VHD) in the elderly. Imaging defines the structure and function of the cardiac system, refining the understanding of patients' anatomy and physiology and informing a host of clinical care...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2014.07.003
更新日期：2014-09-01 00:00:00
abstract：:With the approval of alteplase (tPA) therapy for stroke, it is likely that combination therapy with tPA to restore blood flow, and agents like glutamate receptor antagonists to halt or reverse the cascade of neuronal damage, will dominate the future of stroke care. The authors describe events and potential targets of ...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(99)70002-2
更新日期：1999-11-01 00:00:00
abstract：:The role of metabolic processes in the control of the normal circulation will be discussed with particular emphasis on how metabolic events, particularly those that occur with the performance of exercise, result in production of vasoactive substances and sympathetic activation. Heart failure patients will have altered...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(05)80013-1
更新日期：1995-07-01 00:00:00
abstract：:The success of modern therapies in congenital heart disease has produced a large and growing population of adults with congenital heart disease as a chronic condition. Such success increasingly raises a host of ethical issues, from resource utilization to end of life decision-making. The importance of a multidisciplin...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2012.10.004
更新日期：2012-11-01 00:00:00
abstract：:The pharmacologic regulation of lipid metabolism in patients with dyslipidemia is unequivocally associated with significant reductions in risk for cardiovascular morbidity and mortality. A number of therapeutic drug classes have been developed in an effort to ever more precisely and intensively modulate lipid metaboli...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2004.04.007
更新日期：2004-09-01 00:00:00
abstract：:The use of noninvasive stress cardiac imaging for stratifying risk in patients with known or suspected coronary artery disease is growing as a tool for identification of the subgroup most likely to benefit from the expense and risk of more invasive procedures, including cardiac catheterization and coronary revasculari...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1053/pcad.2000.19314
更新日期：2000-11-01 00:00:00
abstract：:Sugars are foundational to biological life and played essential roles in human evolution and dietary patterns for most of recorded history. The simple sugar glucose is so central to human health that it is one of the World Health Organization's Essential Medicines. Given these facts, it defies both logic and a large b...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2018.04.007
更新日期：2018-01-01 00:00:00
abstract：:People are at risk from noncommunicable diseases (NCD) and poor health habits, with interventions like medications and surgery carrying further risk of adverse effects. This paper addresses ways people are increasingly moving to healthy living medicine (HLM) to mitigate such health threats. HLM-seekers increasingly le...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2016.12.006
更新日期：2017-01-01 00:00:00
abstract：:Barometric pressure falls with increasing altitude and consequently there is a reduction in the partial pressure of oxygen resulting in a hypoxic challenge to any individual ascending to altitude. A spectrum of high altitude illnesses can occur when the hypoxic stress outstrips the subject's ability to acclimatize. Ac...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2010.02.003
更新日期：2010-05-01 00:00:00
abstract：:Telecardiology holds great promise for Africa, from tele-echocardiography and tele-ECG s, to home monitoring and text messaging for medication adherence monitoring. The burden of disease is great and there is an extreme shortage of health professionals. Telemedicine can provide access to scarce specialist care, improv...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2013.10.006
更新日期：2013-11-01 00:00:00
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journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2019.10.001
更新日期：2019-01-01 00:00:00
abstract：:Left ventricular (LV) ejection fraction (EF) and LV end-systolic volumes are important measures of LV global function. However, in many patients with symptoms of heart failure, these measures are within normal limits. This condition is classified as heart failure with normal ejection fraction (HFNEF). Reduced EF and i...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2006.08.008
更新日期：2006-11-01 00:00:00
abstract：:There has been a lot of progress in measurement techniques of the pulmonary circulation in recent years, and this has required updating of basic physiological knowledge. Pulmonary artery pressures (PAP) are normally low and dependent on left atrial pressure (LAP) and cardiac output (CO). Therefore, defining the functi...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2014.12.003
更新日期：2015-03-01 00:00:00
abstract：:The role of antiarrhythmic agents in the post-MI patients has been investigated for several years. Recently, clinical trials have assessed the effects of amiodarone in the post-MI population. The Basel Antiarrhythmic Study of Infarct Survival (BASIS) trial showed a reduction in total mortality, sudden death, and life-...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(98)80023-6
更新日期：1998-07-01 00:00:00
abstract：:Tumor necrosis factor alpha (TNF-alpha), a protein belonging to the family of cytokines, is one of the leading mediators of the immune response to inflammation. Its widespread biological effects are modulated by two circulating binding proteins corresponding to the extracellular domain of the membrane receptors, namel...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(98)80028-5
更新日期：1998-07-01 00:00:00
abstract：:The first step in the diagnostic evaluation of patients with suspected syncope begins with an "initial evaluation" consisting of careful history taking, physical examination including orthostatic blood pressure measurement and electrocardiogram. However, even in expert centers the diagnostic yield of this "initial eva...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2012.11.002
更新日期：2013-01-01 00:00:00
abstract：:In recent years, a number of peptide and nonpeptide signalling autacoids have been implicated in the regulation of cardiac myocyte growth as well as vasculogenesis and angiogenesis, and in the function of cardiac muscle following development. In this review, we first examine the evidence for a role for specific cytoki...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(97)80033-3
更新日期：1997-01-01 00:00:00
abstract：:There is a strong evidence that more marked lowering of low-density lipoprotein cholesterol (LDL-C) leads to progressively lower risk of cardiovascular disease (CVD) events. The evidence on validity of this hypothesis comes from epidemiological, genetic and clinical studies. The hypothesis "the lower the better" has b...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/j.pcad.2020.12.008
更新日期：2020-12-28 00:00:00
abstract：:The decrease in ovarian function culminating in the last menstrual period, the menopause, in women in their forties and fifties takes place over a period of 3 to 5 years. There are several immediate clinical consequences of the menopause that are easy to detect and treat, usually with hormone replacement. In contrast,...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/s0033-0620(95)80010-7
更新日期：1995-11-01 00:00:00
abstract：:Slow channel inhibiting agents, particularly verapamil, appear to produce beneficial effects in relieving symptoms of dyspnea, chest pain, and syncope or presyncope in over 70% of patients with hypertrophic cardiomyopathy. Symptomatic relief occurs in patients with and without left ventricular outflow obstruction. Exe...
journal_title：Progress in cardiovascular diseases
pub_type： 杂志文章,评审
doi：10.1016/0033-0620(82)90016-0
更新日期：1982-11-01 00:00:00
