Comparative cost effectiveness

Comparative cost effectiveness and clinical efficacy of modelling in CoA


Comparative benefit of cardiovascular modelling remains under-researched and, in particular, the following questions remain unanswered:

  • Comparative effect on clinical decision-making: Would modelling methods result in different treatment decisions?
  • Comparative effect on clinical outcomes: Would modelling methods have an effect on clinically relevant outcomes such as hospital readmissions and mortality?
  • Comparative effect on costs: What are the incremental costs and benefits associated with use of modelling methods (costs associated to refined indication/timing of intervention) both in the short- and medium-term?

To address these questions CARDIOPROOF will:

  • compare treatment decisions and costs associated with cardiovascular modelling as opposed to the traditional approach of following clinical practice guidelines
  • extrapolate short- and medium-term findings from the CoA trial to simulate long-term comparative clinical and cost-effectiveness of different modelling approaches relative to existing clinical practice guideline

Cardiovascular modelling has large potential to influence therapeutic decisions that “further downstream” are the dominant factor for outcome. Yet, comparative benefit of cardiovascular modelling remains under-researched within both clinical and economic domains. In particular, the following questions remain unanswered:

  • Comparative effect on clinical decision-making: Do modelling methods result in different treatment decisions?

  • Comparative effect on clinical outcomes: Do modelling methods have an effect on clinically relevant outcomes such as hospital readmissions and mortality?

  • Comparative effect on costs: What are the incremental costs and benefits associated with use of modelling methods (costs associated to refined indication/timing of intervention) both in the short- and medium-term?

To address these questions, one of the objectives of CARDIOPROOF will be to first compare the treatment decisions and costs associated with cardiovascular modelling as opposed to the traditional approach of following clinical practice guidelines. Second, CARDIOPROOF will extrapolate the short and medium-term findings from the exploratory trial of CoA to simulate the long-term comparative clinical and cost-effectiveness of different modelling approaches relative to existing clinical practice guidelines.

The hypothesis for this comparative clinical and cost-effectiveness simulation is that modelling methods will result in different procedure utilization patterns with subsequent differences in interventions, which would collectively have an impact on long-term clinical and cost-effectiveness. To test this hypothesis, CARDIOPROOF will develop a simulation model to estimate the long-term comparative clinical and cost-effectiveness of cardiovascular modelling approaches relative to clinical practice guidelines.

By combining the clinical and economic data components obtained from the exploratory trial, in addition to a focused systematic review, the simulation model will address the question: what are the incremental costs and clinical effects associated with the use of modelling methods (costs associated with refined indication and timing of intervention)?

In addition to providing comparative clinical- and cost-effectiveness information on cardiovascular modelling for the first time, the simulation model will benefit future attempts at evaluating the clinical and economic value of cardiovascular modelling. The overall simulation model structure will be flexible to allow for country and setting adaptations with different utilization patterns and cost parameters. By incorporating the findings of future research findings to populate the simulation model, this simulation will have the potential to serve as a basis for future research in estimating the comparative clinical and cost-effectiveness of cardiovascular modelling approaches.