{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:23:29Z","timestamp":1790360609878,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Multidisciplinary Shock Teams have improved clinical outcomes for cardiogenic shock, but their implementation costs have not been studied. This study\u2019s objective was to compare costs between patients treated with and without a Shock Team and determine if the team\u2019s implementation is cost-effective compared with standard of care.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We examined patients with refractory cardiogenic shock treated with or without a Shock Team at a tertiary academic hospital from 2009 to 2018. Real-world hospital data were used to compare costs and outcomes, including survival at discharge, 1-year survival, and quality-adjusted life years gained at 1 year. Incremental cost-effectiveness ratios were calculated over a 1-year time horizon, with parameter uncertainty evaluated through probabilistic sensitivity analysis using 1000 second-order Monte Carlo simulations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              The study involved 244 patients, with 123 treated by the Shock Team and 121 receiving standard of care. Patients were predominantly male (77.5%), with a mean age of 58 (18\u201392) years. The Shock Team approach improved survival rates at hospital discharge and 1-year follow-up (61.0% versus 47.9%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.04 and 55.0% versus 40.5%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.03, respectively). The incremental cost-effectiveness ratio for increases in survival probability at discharge for the multidisciplinary Shock Team compared with standard of care was $102\u2005088. The incremental cost-effectiveness ratio for increases in survival probability at 1-year was estimated at $96\u2005152 and at $127\u2005862 per 1 quality-adjusted life year gained. Probabilistic sensitivity analysis estimates showed that the Shock Team was cost-effective in the majority of simulations using a willingness-to-pay threshold of $150\u2005000, while it was also dominant in almost one-third of the simulations.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The Shock Team approach for treating refractory cardiogenic shock may be a cost-effective alternative to traditional standard of care. These findings can help prioritize the implementation of Shock Team initiatives to further improve cardiogenic shock outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.124.011709","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T09:01:02Z","timestamp":1729242062000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Cost-Effectiveness of a Shock Team Approach in Refractory Cardiogenic Shock"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0029-5019","authenticated-orcid":true,"given":"Iosif","family":"Taleb","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine (I.T., C.P.K., K.S., E.T., K.S.S., E.D., T.L.J., S.J.C., J.C.F., J.S., T.C.H., S.G.D.), University of Utah School of Medicine, Salt Lake City."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros V.","family":"Giannouchos","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham (T.V.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9415-1245","authenticated-orcid":true,"given":"Christos P.","family":"Kyriakopoulos","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (I.T., C.P.K., K.S., E.T., K.S.S., E.D., T.L.J., S.J.C., J.C.F., J.S., T.C.H., S.G.D.), University of Utah School of Medicine, Salt Lake City."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9559-9506","authenticated-orcid":true,"given":"Antoine","family":"Clawson","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Utah Health, Salt Lake City (A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6112-0685","authenticated-orcid":true,"given":"Erin S.","family":"Davis","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Utah Health Transplant Service Line, Salt Lake City (E.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9369-0782","authenticated-orcid":true,"given":"Konstantinos","family":"Sideris","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (I.T., C.P.K., K.S., E.T., K.S.S., E.D., T.L.J., S.J.C., J.C.F., J.S., T.C.H., S.G.D.), University of Utah School of Medicine, Salt Lake City."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9350-2282","authenticated-orcid":true,"given":"Eleni","family":"Tseliou","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (I.T., C.P.K., K.S., E.T., K.S.S., E.D., T.L.J., S.J.C., J.C.F., J.S., T.C.H., S.G.D.), University of Utah School of Medicine, Salt Lake City."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (I.T., C.P.K., K.S., E.T., K.S.S., E.D., T.L.J., S.J.C., J.C.F., J.S., T.C.H., S.G.D.), University of Utah School of Medicine, Salt Lake City."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8879-2628","authenticated-orcid":true,"given":"Joseph E.","family":"Tonna","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery (J.E.T., C.H.S.), University of Utah School of Medicine, Salt Lake City."},{"name":"Department of Emergency Medicine, University of Utah Health, Salt Lake City 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