{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:43:20Z","timestamp":1790790200153,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T00:00:00Z","timestamp":1641427200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009032","name":"Pfizer UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009032","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our primary aim was to evaluate the healthcare resource use associated with the diagnosis of transthyretin amyloidosis cardiomyopathy. Second, we aim to assess the effect of the number of diagnostic tests and clinical contact points on the total time and costs between symptom onset and diagnosis defining a quantitative hypothetical optimized diagnostic pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Clinical and cost data were collected from patients presenting between 2010 and 2018 in a tertiary referral institution in South London involving two participating hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Thirty\u2010eight adult patients with a definite diagnosis of transthyretin amyloidosis cardiomyopathy were included, mostly male (n\u00a0=\u00a028, 74%) and of African\u2010Caribbean descent (n\u00a0=\u00a023, 64%). We excluded patients without a confirmed transthyretin amyloidosis cardiomyopathy or those on inotersen, patisiran, or diflunisal at point of referral.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>The average time between first presentation and final diagnosis, and the cost per patient per month. By comparing to a more optimal clinical pathway towards diagnosis, we considered what could be the theoretical gain in terms of time to diagnosis and financial savings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average time between first presentation and final diagnosis was 2.74\u2009years. The average cost per patient per month was higher with progressive heart failure symptoms. A hypothetical optimal pathway reduces time to diagnosis of 1.65 to 1.74\u2009years per patient. The potential financial savings are estimated within the range of \u00a33000 to \u00a34800 per patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients diagnosed with transthyretin amyloidosis cardiomyopathy have substantial healthcare resource utilization and costs starting from symptom onset. Higher costs were observed with progression in symptoms and appear linked to a delayed diagnosis. The number of additional diagnostic tests and clinical contact points may contribute to this and could represent a path to explore further for important health and cost savings, with more efficient pathways for these patients to be managed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.466","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T08:51:27Z","timestamp":1641459087000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Healthcare resource use associated with the diagnosis of transthyretin amyloidosis cardiomyopathy"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3355-9850","authenticated-orcid":false,"given":"Clint","family":"Asher","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences Rayne Institute, King's College London  London UK"},{"name":"Department of Cardiology Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Guilder","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences Rayne Institute, King's College London  London UK"},{"name":"Care Redesign Improvement and Innovation System Guy's and St Thomas NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gherardo","family":"Finocchiaro","sequence":"additional","affiliation":[{"name":"Department of Cardiology Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerry","family":"Carr\u2010White","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences Rayne Institute, King's College London  London UK"},{"name":"Department of Cardiology Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Rodr\u00edguez\u2010Guadarrama","sequence":"additional","affiliation":[{"name":"Wellcome EPSRC Centre for Medical Engineering, School of Biomedical Engineering and Imaging Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/13506129.2020.1835263"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/13506120308998998"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40119-020-00169-4"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40119-021-00222-w"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.078915"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12286"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.09.006"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.12.1425"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.024438"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/13506129.2016.1272453"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2015.1068949"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1695"},{"key":"e_1_2_14_14_1","unstructured":"GillmoreJ LachmannH PepysM et al.NATIONAL AMYLOIDOSIS CENTRE Centre for Amyloidosis & Acute Phase Proteins Department of Medicine Hampstead Campus University College London Royal Free Hospital. 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