{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:27:05Z","timestamp":1782912425223,"version":"3.54.5"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T00:00:00Z","timestamp":1693699200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["RC-2022-2773270"],"award-info":[{"award-number":["RC-2022-2773270"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To conduct a contemporary cost-effectiveness analysis examining the use of implantable cardioverter defibrillators (ICDs) for primary prevention in patients with hypertrophic cardiomyopathy (HCM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A discrete-time Markov model was used to determine the cost-effectiveness of different ICD decision-making rules for implantation. Several scenarios were investigated, including the reference scenario of implantation rates according to observed real-world practice. A 12-year time horizon with an annual cycle length was used. Transition probabilities used in the model were obtained using Bayesian analysis. The study has been reported according to the Consolidated Health Economic Evaluation Reporting Standards checklist.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Using a 5-year SCD risk threshold of 6% was cheaper than current practice and has marginally better total quality adjusted life years (QALYs). This is the most cost-effective of the options considered, with an incremental cost-effectiveness ratio of \u00a3834 per QALY. Sensitivity analyses highlighted that this decision is largely driven by what health-related quality of life (HRQL) is attributed to ICD patients and time horizon.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We present a timely new perspective on HCM-ICD cost-effectiveness, using methods reflecting real-world practice. While we have shown that a 6% 5-year SCD risk cut-off provides the best cohort stratification to aid ICD decision-making, this will also be influenced by the particular values of costs and HRQL for subgroups or at a local level. The process of explicitly demonstrating the main factors, which drive conclusions from such an analysis will help to inform shared decision-making in this complex area for all stakeholders concerned.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcad050","type":"journal-article","created":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T04:49:37Z","timestamp":1693716577000},"page":"285-293","source":"Crossref","is-referenced-by-count":9,"title":["A cost-effectiveness analysis of hypertrophic cardiomyopathy sudden cardiac death risk algorithms for implantable cardioverter defibrillator decision-making"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2745-1736","authenticated-orcid":false,"given":"Nathan","family":"Green","sequence":"first","affiliation":[{"name":"Department of Statistical Science, University College London , 1-19 Torrington Place, London WC1E 6BT , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6032-3387","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, Faculty of Population Health Sciences, University College London , London WC1E 6BT , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantinos","family":"O'Mahony","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London , Gower St, London WC1E 6BT, UK"},{"name":"St Bartholomew's Hospital , London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perry M","family":"Elliott","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London , Gower St, London WC1E 6BT, UK"},{"name":"St Bartholomew's Hospital , London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6721-3487","authenticated-orcid":false,"given":"Roberto","family":"Barriales-Villa","sequence":"additional","affiliation":[{"name":"Unidad de Cardiopat\u00edas Familiares, Cardiology Service, Complexo Hospitalario Universitario A Coru\u00f1a, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC, CIBERCV) , A Coru\u00f1a 15006 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5776-0623","authenticated-orcid":false,"given":"Lorenzo","family":"Monserrat","sequence":"additional","affiliation":[{"name":"Unidad de Cardiopat\u00edas Familiares, Cardiology Service, Complexo Hospitalario Universitario A Coru\u00f1a, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC, CIBERCV) , A Coru\u00f1a 15006 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristides","family":"Anastasakis","sequence":"additional","affiliation":[{"name":"Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Centre , Leof. Andrea Siggrou 356, Kallithea 176 74 , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0295-0440","authenticated-orcid":false,"given":"Elena","family":"Biagini","sequence":"additional","affiliation":[{"name":"Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Via Massarenti 9, Bologna 40138 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Ramon","family":"Gimeno","sequence":"additional","affiliation":[{"name":"Cardiac Department, University Hospital Virgen Arrixaca , Murcia-Cartagenas, El Palmar, Murcia 30120 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8291-9517","authenticated-orcid":false,"given":"Giuseppe","family":"Limongelli","sequence":"additional","affiliation":[{"name":"Monaldi Hospital, Second University of Naples , Via Leonardo Bianchi 1, Naples 80131 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menelaos","family":"Pavlou","sequence":"additional","affiliation":[{"name":"Clinical Research Informatics Unit, University College London Hospitals , London NW1 2DA , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumana Z","family":"Omar","sequence":"additional","affiliation":[{"name":"Clinical Research Informatics Unit, University College London Hospitals , London NW1 2DA , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,2]]},"reference":[{"key":"2024062010205678500_bib1","volume-title":"2020 AHA\/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. 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