{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T10:39:42Z","timestamp":1778841582094,"version":"3.51.4"},"reference-count":53,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,3,25]],"date-time":"2016-03-25T00:00:00Z","timestamp":1458864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2016,4]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Blunt cardiac injury severe enough to require surgical intervention (sBCI<\/jats:styled-content>) is an exceedingly rare event occurring in approximately 1 out of every 1600 trauma patients. While performing the cardiac component of the Focused Assessment of Sonography in Trauma (cFAST<\/jats:styled-content>) exam is effective in penetrating trauma, it is unclear whether it is of value in blunt trauma given the low prevalence of sBCI<\/jats:styled-content>, the imperfect test characteristics of the FAST<\/jats:styled-content> exam, and the rate of incidental pericardial effusion.<\/jats:p><\/jats:sec>Objective<\/jats:title>The objective was to determine through decision analysis whether performing the cFAST<\/jats:styled-content> exam is cost\u2010effective in the evaluation of hypotensive and normotensive blunt trauma patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>We created two decision analytic models using commercially available software (TreeAgePro2011) to evaluate the cost\u2010effectiveness of the cFAST<\/jats:styled-content> in hypotensive (systolic blood pressure <90\u00a0mm\u00a0Hg) and normotensive blunt trauma patients. Clinical probabilities were obtained from published data. Costs were estimated from Medicare reimbursement and charge data. The willingness\u2010to\u2010pay threshold was $50,000\/quality\u2010adjusted life\u2010years (QALY<\/jats:styled-content>s). Sensitivity analyses were performed over plausible ranges using available literature.<\/jats:p><\/jats:sec>Results<\/jats:title>In hypotensive patients, for the base case scenario of a 34\u2010year\u2010old with blunt trauma, the cFAST<\/jats:styled-content> strategy had a cost of $42,882.70 and an effectiveness of 25.3597 QALY<\/jats:styled-content>s, whereas the no cFAST<\/jats:styled-content> strategy had a cost of $42,753.52 and an effectiveness of 25.3532 QALY<\/jats:styled-content>s. The incremental cost\u2010effectiveness ratio (ICER<\/jats:styled-content>) was $19,918\/QALY<\/jats:styled-content>. For normotensive patients the cFAST<\/jats:styled-content> strategy had a cost of $18,331.03 and an effectiveness of 23.2817 QALY<\/jats:styled-content>s, whereas the no cFAST<\/jats:styled-content> strategy had a cost of $18,207.58 and an effectiveness of 23.2814 QALY<\/jats:styled-content>s. The ICER<\/jats:styled-content> was $465,867\/QALY<\/jats:styled-content>. In the sensitivity analyses, age, probability of death from sBCI<\/jats:styled-content> with prompt treatment, and probability of sBCI<\/jats:styled-content> were the main drivers of variability in the model outcomes.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The cFAST<\/jats:styled-content> for blunt trauma is cost\u2010effective for hypotensive but not for normotensive patients. The ICER<\/jats:styled-content> for hypotensive patients was more than 20 times higher than the ICER<\/jats:styled-content> for normotensive patients. Our results suggest that performing the cFAST<\/jats:styled-content> exam may not be an effective use of resources in normotensive blunt trauma patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12936","type":"journal-article","created":{"date-parts":[[2016,2,9]],"date-time":"2016-02-09T09:04:23Z","timestamp":1455008663000},"page":"415-423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Cost\u2010effectiveness of the Cardiac Component of the Focused Assessment of Sonography in Trauma Examination in Blunt Trauma"],"prefix":"10.1111","volume":"23","author":[{"given":"M. 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