{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T07:09:17Z","timestamp":1768633757258,"version":"3.49.0"},"reference-count":50,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009882","name":"Regione Lombardia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009882","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Economics"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Real\u2010world data are considered a potentially valuable source of evidence for assessing medical technologies in clinical practice, but their widespread use is hampered by numerous challenges. Using the case of coronary stents in Italy, we investigate the potential of administrative databases for estimating costs and health outcomes associated with the use of medical devices in real world conditions. An administrative dataset was created ad hoc by merging hospital records from patients admitted between 2013 and 2019 for stent implantations with ambulatory records, pharmaceutical use data and vital statistics. Health outcomes were multifold: all\u2010cause and cardiac mortality and myocardial infarction, within 30\u00a0days, 1, 2, 5\u00a0years. Costs were estimated from the National Health System perspective. We used multivariable Cox models and propensity score (PS) methods (PS matching; stratification on PS; inverse probability of treatment weighting using PS; PS adjustment). 257,907 coronary stents were implanted in 113,912 patients. For all health outcomes and follow\u2010up times, and across all methods, patients receiving drug\u2010eluting stents (DES) presented lower risk. For all\u2010cause mortality, the DES patient advantage over bare\u2010metal stent (BMS) patients declined over time but remained significant even at 5\u00a0years. For myocardial infarction, results remained quite stable. The DES group presented lower cumulative total costs (ranging from 3264 to 2363 Euros less depending on methods). Our results confirm the consolidated evidence of the benefits of DES compared to BMS. The consistency of results across methods suggests internal validity of the study, while highlighting strengths and limitations of each depending on research context. Administrative data yield great potential to perform comparative effectiveness and cost\u2010effectiveness analysis of medical devices provided certain conditions are met.<\/jats:p>","DOI":"10.1002\/hec.4562","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T10:46:34Z","timestamp":1656413194000},"page":"25-43","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["How real can we get in generating real world evidence? Exploring the opportunities of routinely collected administrative data for evaluation of medical devices"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8539-1554","authenticated-orcid":false,"given":"Benedetta","family":"Pongiglione","sequence":"first","affiliation":[{"name":"Centre for Research on Health and Social Care Management Bocconi University  Milano Lombardia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Torbica","sequence":"additional","affiliation":[{"name":"Centre for Research on Health and Social Care Management Bocconi University  Milano Lombardia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pst.433"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5705"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5984"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7084"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6607"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.08.3019"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607991"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.21105\/joss.01593"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.7086"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2010.10.004"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1501500305"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2018.11.010"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5083\/ejcm.20424884.10"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.04858"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2020.11.003"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/vhrm.s162004"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2018.02.004"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/mlr.0b013e31822d5de9"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3080-3"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.21105\/joss.00648"},{"key":"e_1_2_9_24_1","unstructured":"Gray B. &Gray M. B.(2020).Package \u2018cmprsk\u2019."},{"key":"e_1_2_9_25_1","unstructured":"Greifer N.(2022).Estimating effects after matching. Retrieved fromhttps:\/\/cran.r\u2010project.org\/web\/packages\/MatchIt\/vignettes\/estimating\u2010effects.html#after\u2010pair\u2010matching\u2010with\u2010replacement"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648\u2010200009000\u201000012"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwv254"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v042.i08"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26479"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.826479"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu366"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.2307\/2533947"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.03.008"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1489-0"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq\u20102019\u2010000712"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.049"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.2217\/cer\u20102021\u20100137"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462306051336"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30474-X"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0266462321000301"},{"key":"e_1_2_9_42_1","first-page":"553","volume-title":"Advances in longitudinal data analysis","author":"Robins J.","year":"2009"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs215"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1214\/09\u2010sts313"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462310001340"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3469"},{"issue":"10","key":"e_1_2_9_47_1","first-page":"28","article-title":"Package survival","volume":"128","author":"Therneau T. M.","year":"2015","journal-title":"R Top Doc"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2020.09.015"},{"issue":"13","key":"e_1_2_9_49_1","first-page":"1","article-title":"Ipw: An R package for inverse probability weighting","volume":"43","author":"Van Der W.","year":"2011","journal-title":"Journal of Statistical Software"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.08.3018"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-78"}],"container-title":["Health Economics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hec.4562","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hec.4562","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hec.4562","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T02:51:13Z","timestamp":1722653473000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hec.4562"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,28]]},"references-count":50,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/hec.4562"],"URL":"https:\/\/doi.org\/10.1002\/hec.4562","archive":["Portico"],"relation":{},"ISSN":["1057-9230","1099-1050"],"issn-type":[{"value":"1057-9230","type":"print"},{"value":"1099-1050","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,28]]},"assertion":[{"value":"2021-11-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}