Leiner_edit.qxp 28/7/08 12:44 pm Page 57
Cost-effectiveness of Gadofosveset in Symptomatic Peripheral Arterial Occlusive Disease
inferior to that of ECCM-enhanced MRA (86%), but the number of non-
Figure 6: Sensitivity Analysis of Values for the Probability of
assessable images was found to be lower with gadofosveset (5–18 versus
Obtaining Diagnostic Confidence Following Initial Magnetic
9–28%).
33
More clinical studies are ongoing to provide not only the
Resonance Angiography in Intermittent Claudication
diagnostic value in terms of sensitivity, specificity and accuracy, but also data
on diagnostic confidence, assessed in intra-individual comparison trials with
1.0
GF-MRA
all three procedures – DSA and gadofosveset- and ECCM-enhanced MRA.
0.8
ECCM-MRA
Overall, this cost-effectiveness analysis showed promising results, especially
in view of the use of ‘real-world’ diagnostic confidence as obtained from the
0.6
Delphi panel in constructing the model and predicting its consequences.
Nevertheless, further research with regard to efficacy, utility and resource
0.4
use for diagnostic procedures in PAOD will be required, along with
additional sensitivity analyses to further evaluate the effects of several
0.2
parameters based on the findings of the ongoing clinical studies with respect
Probability of diagnostic confidence after MRA (ECCM)
to the diagnostic confidence. ■
0.0
0.0 0.2 0.4 0.6 0.8 1.0
Acknowledgements
The Delphi panel comprised the following experts: Dr A Huppertz
Probability of diagnostic confidence after MRA (GF)
(Charité, Berlin), Dr T Leiner (Maastricht University Hospital, The
Payer perspective, base case I. Details as for Figure 2.
Netherlands), Dr K Nikolaou (University Hospital Großhadern, Munich), Dr
R Puls (University Hospital, Greifswald), Dr J Rieger (University Hospital Willinek (Radiological University Hospital, Bonn). We thank them warmly
Innenstadt, Munich), Dr T Überrück (University Hospital, Jena) and Dr W for their contribution to this work.
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EUROPEAN CARDIOLOGY 57
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