title: An educational tool to illustrate cost-effectiveness in diagnostic pathways for coronary artery disease.
abstract: Rapid increases in healthcare costs have led to increased interest in the cost-effectiveness of medical interventions. Coronary artery disease is responsible for a significant share of total healthcare spending, and therefore economic evaluations of medical procedures to treat the condition are potentially very important. We have developed a spreadsheet model as an educational tool that can be used to illustrate cost-effectiveness in the selection of diagnostic pathways (a "work-up" strategy of tests designed to reach a final diagnosis) for coronary artery disease. The model, in Microsoft Excel, is easy to use, requiring no specialist computer knowledge. It is menu-driven and the user navigates the model via a number of on-screen buttons. A data entry screen allows the user to customize the data for the key model parameters, making it possible to take into account location-specific features. The data entry screen also allows the user to undertake sensitivity analysis and rate "what if" scenarios. The model demonstrates how sensitive the cost-effectiveness of different diagnostic pathways is to the pretest probability of disease. This package could also be used as a decision support tool, although it is important to recognize some of its limitations for this purpose.
authors.affiliation: Division of Public Health Sciences, King's College London, (Guy's Campus), United Kingdom.
authors.forename: P B
authors.initials: PB
authors.lastname: Jacklin
authors.forename: P A
authors.initials: PA
authors.lastname: West
authors.forename: D
authors.initials: D
authors.lastname: Sariklis
authors.forename: R
authors.initials: R
authors.lastname: Beech
authors.forename: M N
authors.initials: MN
authors.lastname: Maisey
mesh_terms: D003327:Coronary Disease / Q000175:diagnosis* / Q000191:economics; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000191:economics*; D020000:Decision Support Systems, Clinical / Q000191:economics; D006801:Humans; D018803:Models, Economic; D012984:Software