{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T06:27:25Z","timestamp":1780986445532,"version":"3.54.1"},"reference-count":25,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Bristol Myers Squibb","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,22]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the resource use of patients with obstructive hypertrophic cardiomyopathy (HCM), stratified by New York Heart Association (NYHA) class, in the English and Northern Irish healthcare systems via expert elicitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Modified Delphi framework methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>UK HCM secondary care centres (n=24).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Cardiologists who actively treated patients with HCM were eligible, of whom 10 from English and Northern Irish centres participated. Recruitment of participants to the study was limited to one expert per site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Responses were collected by electronic quantitative survey. Following the discussion of survey results in a virtual panel, aggregated responses from a final survey were analysed and stratified by NYHA class. Data were analysed without (base case) and with (scenario) interventional cardiologists who conduct septal reduction therapies (SRTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Based on expert opinion, as NYHA class increased, so did the mean\u00b195% CI number of primary care consultations (classes I\u2013IV: 0.64\u00b10.35; 1.07\u00b10.33; 3.29\u00b11.02; 6.00\u00b12.46, respectively) per patient per annum. This was also observed across all types of secondary care consultations, such as mean\u00b195%\u2009CI number of cardiovascular-related outpatient visits (classes I\u2013IV: 0.69\u00b10.26; 0.88\u00b10.24; 2.13\u00b10.78; 3.25\u00b11.42, respectively) and inpatient admissions (classes I\u2013IV: 0.01\u00b10.01; 0.04\u00b10.07; 0.94\u00b10.39; 1.90\u00b10.65, respectively) per annum. Patients in NYHA class III were most likely to undergo SRT in their lifetime (mean\u00b195%\u2009CI proportion of patients:17.25%\u00b17.19% or 26.30%\u00b113.61% including interventionalists). Across NYHA, experts estimated that septal myectomy was more costly than alcohol septal ablation (mean\u00b195%\u2009CI: \u00a315 675\u00b1\u00a310 556\u2009vs \u00a36750\u00b1\u00a35900, respectively). Prescription of beta-blockers was higher than calcium channel blockers, irrespective of NYHA class.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Treatment of obstructive HCM is associated with a substantial clinical and economic burden in England and Northern Ireland; the burden of the disease increasing with NYHA class is driven by the need for intensive disease management, hospitalisations and the potential burden of undertaking SRTs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-080142","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T15:39:35Z","timestamp":1734968375000},"page":"e080142","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Modified Delphi expert elicitation of the clinical and economic burden of obstructive hypertrophic cardiomyopathy in England and Northern Ireland"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9360-0280","authenticated-orcid":false,"given":"Michael","family":"Hurst","sequence":"first","affiliation":[{"name":"Bristol Myers Squibb, Uxbridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Zema","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Princeton, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taryn","family":"Krause","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Uxbridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Sandler","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Uxbridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Lemmer","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Uxbridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Noon","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Uxbridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Alexander","sequence":"additional","affiliation":[{"name":"Accession Healthcare Consulting Ltd, Henley-on-Thames, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3962-5118","authenticated-orcid":false,"given":"Faizel","family":"Osman","sequence":"additional","affiliation":[{"name":"Institute for Cardio-Metabolic Medicine, University Hospital Coventry & Warwickshire NHS Trust, University of Warwick Medical School and Coventry University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,22]]},"reference":[{"key":"2025121402353061000_14.12.e080142.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu284"},{"key":"2025121402353061000_14.12.e080142.2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000937"},{"key":"2025121402353061000_14.12.e080142.3","doi-asserted-by":"crossref","first-page":"ehac544.1747","DOI":"10.1093\/eurheartj\/ehac544.1747","article-title":"Population estimates of obstructive and non-obstructive hypertrophic cardiomyopathy in the UK and Germany","volume":"43","author":"Schultze","year":"2022","journal-title":"Eur Heart J"},{"key":"2025121402353061000_14.12.e080142.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.311059"},{"key":"2025121402353061000_14.12.e080142.5","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2021.2011301"},{"key":"2025121402353061000_14.12.e080142.6","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad194"},{"key":"2025121402353061000_14.12.e080142.7","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.541"},{"key":"2025121402353061000_14.12.e080142.8","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/joic.12319","article-title":"Septal Ablation and Hypertrophic Obstructive Cardiomyopathy: 7 Years US Experience","volume":"29","author":"Chothani","year":"2016","journal-title":"J Interv Cardiol"},{"key":"2025121402353061000_14.12.e080142.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.07.075"},{"key":"2025121402353061000_14.12.e080142.10","doi-asserted-by":"crossref","first-page":"E866","DOI":"10.25270\/jic\/22.00150","article-title":"Costs and Healthcare Resource Utilization for Obstructive Hypertrophic Cardiomyopathy With Septal Reduction Therapy","volume":"34","author":"Butzner","year":"2022","journal-title":"J Invasive Cardiol"},{"key":"2025121402353061000_14.12.e080142.11","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1080\/13696998.2021.1978242","article-title":"Clinical and economic burden of obstructive hypertrophic cardiomyopathy in the United States","volume":"24","author":"Jain","year":"2021","journal-title":"J Med Econ"},{"key":"2025121402353061000_14.12.e080142.12","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8776"},{"key":"2025121402353061000_14.12.e080142.13","doi-asserted-by":"publisher","DOI":"10.3310\/hta25590"},{"key":"2025121402353061000_14.12.e080142.14","unstructured":"Krause T , Slater D , Boulton E , et al . An economic systematic literature review for hypetrophic obstructive cardiomyopathy [poster]. Presented at: ISPOR 2024. Atlanta, GA, USA, 2024. Available: https:\/\/www.ispor.org\/docs\/default-source\/intl2024\/krause-et-aleconomic-slr-of-ohcmposterfinalfor-submission25apr24137021-pdf.pdf?sfvrsn=9ca48694_0 [accessed 17 Oct 2024]"},{"key":"2025121402353061000_14.12.e080142.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.08.065"},{"key":"2025121402353061000_14.12.e080142.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.03.066"},{"key":"2025121402353061000_14.12.e080142.17","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11051382","article-title":"Using the NYHA Classification as Forecasting Tool for Hospital Readmission and Mortality in Heart Failure Patients with COVID-19","volume":"11","author":"Citu","year":"2022","journal-title":"J Clin Med"},{"key":"2025121402353061000_14.12.e080142.18","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi555"},{"key":"2025121402353061000_14.12.e080142.19","doi-asserted-by":"crossref","DOI":"10.1016\/j.jval.2022.09.730","article-title":"EE487 Quantifying the Economic Burden of Obstructive Hypertrophic Cardiomyopathy (HCM) in the UK","volume":"25","author":"Hurst","year":"2022","journal-title":"Val Health"},{"key":"2025121402353061000_14.12.e080142.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.04.026"},{"key":"2025121402353061000_14.12.e080142.21","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.3.778"},{"key":"2025121402353061000_14.12.e080142.22","first-page":"1","article-title":"Left ventricular outflow tract obstruction in hypertrophic cardiomyopathy: presurgical and postsurgical evaluation by computed tomography magnetic resonance imaging","volume":"10","author":"White","year":"1996","journal-title":"Am J Card Imaging"},{"key":"2025121402353061000_14.12.e080142.23","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.64.3.437"},{"key":"2025121402353061000_14.12.e080142.24","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s40119-022-00257-7","article-title":"Treatment Changes, Healthcare Resource Utilization, and Costs Among Patients with Symptomatic Obstructive Hypertrophic Cardiomyopathy: A Claims Database Study","volume":"11","author":"Owens","year":"2022","journal-title":"Cardiol Ther"},{"key":"2025121402353061000_14.12.e080142.25","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.000122"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-080142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T10:35:40Z","timestamp":1765708540000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-080142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":25,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,22]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bmjopen-2023-080142"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-080142","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}