{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:48:21Z","timestamp":1772722101544,"version":"3.50.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2006,7,11]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            In the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), implantable cardioverter-defibrillator (ICD) therapy significantly reduced all-cause mortality rates compared with medical therapy alone in patients with stable, moderately symptomatic heart failure, whereas amiodarone had no benefit on mortality rates. We examined long-term economic implications of these results.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Medical costs were estimated by using hospital billing data and the Medicare Fee Schedule. Our base case cost-effectiveness analysis used empirical clinical and cost data to estimate the lifetime incremental cost of saving an extra life-year with ICD therapy relative to medical therapy alone. At 5 years, the amiodarone arm had a survival rate equivalent to that of the placebo arm and higher costs than the placebo arm. For ICD relative to medical therapy alone, the base case lifetime cost-effectiveness and cost-utility ratios (discounted at 3%) were $38 389 per life-year saved (LYS) and $41 530 per quality-adjusted LYS, respectively. A cost-effectiveness ratio &lt;$100 000 was obtained in 99% of 1000 bootstrap repetitions. The cost-effectiveness ratio was sensitive to the amount of extrapolation beyond the empirical 5-year trial data: $127 503 per LYS at 5 years, $88 657 per LYS at 8 years, and $58 510 per LYS at 12 years. Because of a significant interaction between ICD treatment and New York Heart Association class, the cost-effectiveness ratio was $29 872 per LYS for class II, whereas there was incremental cost but no incremental benefit in class III.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Prophylactic use of single-lead, shock-only ICD therapy is economically attractive in patients with stable, moderately symptomatic heart failure with an ejection fraction \u226435%, particularly those in NYHA class II, as long as the benefits of ICD therapy observed in the SCD-HeFT persist for at least 8 years.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.105.581884","type":"journal-article","created":{"date-parts":[[2006,7,5]],"date-time":"2006-07-05T21:28:53Z","timestamp":1152134933000},"page":"135-142","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":216,"title":["Cost-Effectiveness of Defibrillator Therapy or Amiodarone in Chronic Stable Heart Failure"],"prefix":"10.1161","volume":"114","author":[{"given":"Daniel B.","family":"Mark","sequence":"first","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte L.","family":"Nelson","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Anstrom","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana M.","family":"Al-Khatib","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios A.","family":"Tsiatis","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia A.","family":"Cowper","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy E.","family":"Clapp-Channing","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Davidson-Ray","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanne E.","family":"Poole","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Johnson","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill","family":"Anderson","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerry L.","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gust H.","family":"Bardy","sequence":"additional","affiliation":[{"name":"From the Outcomes Research Group (D.B.M., K.J.A., P.A.C., N.C.C., L.D.R.), Duke Clinical Research Institute (K.L.L., C.L.N.); the Division of Cardiology, Department of Medicine, Duke University Medical Center (D.B.M., S.M.A.), Durham, NC; the Department of Statistics, North Carolina State University (A.A.T.), Raleigh, NC; The Seattle Institute for Cardiac Research (G.J., J.A., G.H.B.), Seattle, Wash; and The University of Washington Medical Center (G.H.B., J.E.P.), Seattle, Wash."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.101.4.366"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.17.1702"},{"key":"e_1_3_2_4_2","unstructured":"2003 Drug Topics Red Book. Montvale NJ: Medical Economics Data; 2003."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.02.077"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/87.2.329"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-8-200504190-00007"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199505253322106"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000021407.93752.7b"},{"key":"e_1_3_2_10_2","unstructured":"US Renal Data System. USRDS 2002 Annual Data Report. Bethesda Md: National Institutes of Health; 2002: 529 532."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.24.1.42"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.21.2129"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.103.10.1416"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000015504.57641.d0"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa051989"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.105.581884","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T05:16:15Z","timestamp":1715577375000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.105.581884"}},"subtitle":["Results From the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)"],"short-title":[],"issued":{"date-parts":[[2006,7,11]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2006,7,11]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.105.581884"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.105.581884","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7,11]]},"assertion":[{"value":"2006-07-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}