Table 2.
Distributions used for model parameters in probabilistic sensitivity analysis.
| Variable | Distribution (parameters) | Mean | 95% C.I. based on distribution and parameters |
|---|---|---|---|
| Normal sinus rhythm (NSR) variables | |||
| Probability of remaining in normal sinus rhythm at 1 year for AAD | Beta (α = 26.47, β = 176.11) | 0.26 | (0.17, 0.34) |
| RR of NSR at 1 year with ablation | log normal (exp(μ = 1.07, s.e. = 0.18)) | 2.93 | (2.09, 4.11) |
| Probability (annual) of AF recurrence after NSR with AAD | Beta (α = 20.71, β = 550.23) | 0.036 | (0.00324, 0.00904) |
| Probability (annual) of AF recurrence after NSR with ablation | Beta (α = 122.53, β = 431.47) | 0.221 | (0.023, 0.053) |
| Disutility due to AF | Beta (4.6, 95.4) | 0.046 | (0.014, 0.095) |
|
| |||
| Treatment cost variables | |||
| Annual cost of Amiodarone | Fixed | $433 | |
| Cost of AF ablation hospitalization | Gamma (25, 282.24) | $7,056 | ($4566, $10,709) |
| AF ablation physician fees | Fixed | $2534 | |
| Number of AF ablation procedures | Fixed | 1.27 | |
| Follow-up cost 1st year after ablation | Fixed | $666 | |
|
| |||
| Perioperative ablation complication variables | |||
| Probability of stroke as complication of AF ablation | Beta (α = 17, β = 5648) | 0.003 | (0.0017, 0.0046) |
| Probability of TIA as complication of AF ablation | Beta (α = 13, β = 5454) | 0.002 | (0.0012, 0.0038) |
| Probability of cardiac tamponade as complication of AF ablation | Beta (α = 45, β = 5678) | 0.008 | (0.0057, 0.0010) |
| Probability of PV stenosis as complication of AF ablation | Beta (α = 91, β = 5740) | 0.016 | (0.0017, 0.0049) |
| Cost of stroke as complication from AF ablation | Gamma (α = 25, β = 594.88) | $14872 | ($9624, $21243) |
| Cost of TIA as complication from AF ablation | Gamma (α = 25, β = 171.87) | $4296 | ($2,781, $6137) |
| Cost of cardiac tamponade as complication from AF ablation | Gamma (α = 25, β = 233.69) | $5842 | ($3781, $8345) |
| Cost of PV stenosis as complication from AF ablation | Gamma (α = 25, β = 339.47) | $8487 | ($5492, $12123) |
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| |||
| Pulmonary toxicity variables | |||
| Annual probability of pulmonary toxicity | Beta (6.14, 731.86) | 0.008 | (0.003, 0.016) |
| Probability of death from pulmonary toxicity | Beta (3, 30) | 0.091 | (0.019, 0.208) |
| Probability that pulmonary toxicity is irreversible | Beta (25, 75) | 0.25 | (0.171, 0.338 |
| Cost of acute pulmonary toxicity | Gamma (25, 897.36) | $22434 | ($14518, $32044) |
| Annual cost of irreversible pulmonary toxicity | Gamma (α = 25, β = 151.98) | $3799 | ($2459, $5427) |
| Utility weight for irreversible pulmonary toxicity | Beta (60, 40) | 0.6 | (0.503, 0.693) |
|
| |||
| Ischemic stroke variables | |||
| Annual probability of stroke (Chads2 = 2) | Beta (α = 58.97, β = 1415.21) | 0.04 | (0.031, 0.051) |
| Increase in risk of stroke in the presence of AF | log normal (exp(μ = 0.47, s.e. = 0.18)) | 1.6 | (1.11, 2.30) |
| First year cost of ischemic stroke | Gamma (α = 25, β = 2326.39) | $58159 | ($37638, $83076) |
| Subsequent years of ischemic stroke | Gamma (α = 25, β = 272.2) | $6801 | ($4401, $9715) |
| Utility weight for ischemic stroke | Beta (91.19, 108.80) | 0.46 | (0.39, 0.53) |
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| |||
| Anticoagulation variables | |||
| Proportion of patients on warfarin | Beta (442.2, 562.8) | 0.44 | (0.408, 0.471) |
| Annual cost of warfarin treatment and monitoring | Fixed | $463 | |
| Annual probability of major bleed while being on placebo | Beta (15, 2579.6) | 0.0058 | (0.00324, 0.00904) |
| Relative risk of major bleed warfarin relative to placebo | log normal (exp(μ = −0.798, s.e. = 0.306)) | 0.45 | (0.25, 0.82) |
| Proportion of major bleeds that are ICH | Beta (966.96, 1942.04) | 0.33 | (0.315, 0.350) |
| First year cost of heamorrhagic stroke | Gamma (α = 25, β = 2456.53) | $61413 | ($39743, $87723) |
| Cost for subsequent years of hemorrhagic stroke | Gamma (α = 25, β = 210.10) | $5255 | ($3401, $7507) |
| Utility weight for hemorrhagic stroke | Beta (55.38, 144.62) | 0.28 | (0.22, 0.34) |