@article{19fdfc4bc7ce4253a551ed95eb510c75,
title = "Cost-effectiveness of CT perfusion for patients with acute ischemic stroke (CLEOPATRA)-Study protocol for a healthcare evaluation study",
abstract = "Introduction: Computed tomography perfusion (CTP) is variably considered to assess eligibility for endovascular thrombectomy (EVT) in acute ischemic (AIS) stroke patients. Although CTP is recommended for patient selection in later (6-24 h) time window, it is currently not recommended in the earlier (0-6 h) time window and the costs and health effects of including CTP for EVT selection remain unknown. We aim to estimate the costs and health effects of using CTP for EVT selection in AIS patients compared to conventional selection. Patients and methods: CLEOPATRA is a healthcare evaluation study using clinical and imaging data from multiple, prospective EVT trials and registries in both the earlier and later time windows. To study the long-term health and cost effects, we will construct a ({"}Markov{"}) health state transition model simulating the clinical outcome over a 5-year follow-up period for CTP-based and conventional selection for EVT. Clinical data acquired within the current study and estimates from the literature will be used as input for probabilities of events, costs, and Quality-Adjusted Life Years (QALYs) per modified Rankin Scale (mRS) subscore. Primary outcome for the cost-effectiveness analysis will be the Incremental Cost-Effectiveness Ratio (ICER) in terms of costs per QALY gained over the simulated follow-up period. Study outcomes: Outcome measures will be reported as cumulative values over a 5-year follow-up period. Discussion: This study will provide preliminary insight into costs and health effects of including CTP in the selection for EVT for AIS patients, presenting between 0 and 24 h after time last known well. The results may be used to develop recommendations and inform further implementation projects and studies.",
keywords = "Stroke, endovascular thrombectomy, CT perfusion, cost-effectiveness, THROMBECTOMY, GUIDELINES, THERAPY",
author = "M.S. Koopman and J.W. Hoving and {van Voorst}, H. and J.D. Daems and D. Peerlings and E. Buskens and H.F. Lingsma and H.A. Marquering and {de Jong}, H.W.A.M. and O.A. Berkhemer and {van Zwam}, W.H. and {van Walderveen}, M.A.A. and {van den Wijngaard}, I. and {van der Lugt}, A. and D.W.J. Dippel and A.J. Yoo and B.C.V. Campbell and W.G. Kunz and C.B.L.M. Majoie and B.J. Emmer and {CLEOPATRA Investigators}",
note = "Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: BJE reports grants from LtC (ZonMW and TKI-PPP of Health Holland). WHvZ reports personal fees from Codman and from Stryker. DWJD and AvdL report grants from the Dutch Heart Foundation, AngioCare, Medtronic/Covidien/EV3, MEDAC/LAMEPRO, Penumbra, Top Medical/Concentric, Stryker, and Cerenovus; consultation fees from Stryker, Bracco Imaging, and Servier, received by the Erasmus University Medical Centre outside this project. CBLMM reports grants from TWIN, during the conduct of the study and grants from CVON/Dutch Heart Foundation, European Commission, Dutch Health Evaluation Program, and from Stryker outside this project (paid to institution) and is shareholder of Nicolab. HAM is co-founder and shareholder of Nicolab. All other contributors report no conflicts of interest. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Leading the Change (LtC) (grant number 80-85009-98-2015). LtC is financed by “Health Insurers Netherlands” (Dutch: “Zorgverzekeraars Nederland”) and supports various healthcare evaluations in The Netherlands as part of the “Healthcare Evaluation Netherlands” (Dutch: “Zorgevaluatie Nederland”). LtC was not involved in the design of the project, but progress of the project is continuously monitored by LtC. The MR CLEAN Registry was funded and carried out by the Erasmus University Medical Center, the Academic Medical Center Amsterdam, and the Maastricht University Medical Center. The MR CLEAN Registry was additionally funded by the Applied Scientific Institute for Neuromodulation (TWIN). The CONTRAST consortium is supported by Netherlands Cardiovascular Research Initiative, an initiative of the Dutch Heart Foundation, by the Brain Foundation Netherlands and powered by Health~Holland, Top Sector Life Sciences and receives unrestricted funding from Medtronic and Cerenovus. The primary trial sponsor of CLEOPATRA is Amsterdam UMC, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.{\textquoteright} Publisher Copyright: {\textcopyright} European Stroke Organisation 2022.",
year = "2022",
month = jun,
doi = "10.1177/23969873221092535",
language = "English",
volume = "7",
pages = "188--197",
journal = "European Stroke Journal",
issn = "2396-9873",
publisher = "SAGE Publications Ltd",
number = "2",
}