{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:30:22Z","timestamp":1784788222221,"version":"3.55.0"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,4,2]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Rates of dual antiplatelet therapy (DAPT) after high\u2010risk transient ischemic attack or minor ischemic stroke (TIAMIS) are suboptimal. We performed a cost\u2010effectiveness analysis to characterize the parameters of a quality improvement (QI) intervention designed to increase DAPT use after TIAMIS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We constructed a decision tree model that compared current national rates of DAPT use after TIAMIS with rates after implementing a theoretical QI intervention designed to increase appropriate DAPT use. The base case assumed that a QI intervention increased the rate of DAPT use to 65% from 45%. Costs (payer and societal) and outcomes (stroke, myocardial infarction, major bleed, or death) were modeled using a lifetime horizon. An incremental cost\u2010effectiveness ratio &lt;$100\u2009000 per quality\u2010adjusted life year was considered cost\u2010effective. Deterministic and probabilistic sensitivity analyses were performed. From the payer perspective, a QI intervention was associated with $9657 in lifetime cost savings and 0.18 more quality\u2010adjusted life years compared with current national treatment rates. A QI intervention was cost\u2010effective in 73% of probabilistic sensitivity analysis iterations. Results were similar from the societal perspective. The maximum acceptable, initial, 1\u2010time payer cost of a QI intervention was $28\u2009032 per patient. A QI intervention that increased DAPT use to at least 51% was cost\u2010effective in the base case.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Increasing DAPT use after TIAMIS with a QI intervention is cost\u2010effective over a wide range of costs and proportion of patients with TIAMIS treated with DAPT after implementation of a QI intervention. Our results support the development of future interventions focused on increasing DAPT use after TIAMIS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.032808","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T11:56:06Z","timestamp":1711540566000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Cost\u2010Effectiveness of Increased Use of Dual Antiplatelet Therapy After High\u2010Risk Transient Ischemic Attack or Minor Stroke"],"prefix":"10.1161","volume":"13","author":[{"given":"Paul M.","family":"Wechsler","sequence":"first","affiliation":[{"name":"Department of Neurology, Clinical and Translational Neuroscience Unit Feil Family Brain and Mind Research Institute, Weill Cornell Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6130-2286","authenticated-orcid":false,"given":"Ankur","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Harvard T.H. 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