Table 3.
Base-case results for different pretest probabilities. Dominated strategies not shown, except when significant uncertainty regarding dominance on sensitivity analysis
| Pretest probability | Strategy | Avg cost per patient (I$) | C-E (I$/diag) |
ICER (I$/diag) |
Accuracy (%) | FN (%) |
Deaths (%) | Invasive CA (%) | Negative invasive CA (%) |
| Low | 2 (Ex-ECG→CTA → CA) | 125 | 135 | - | 93 | 7.4 | 0.009 | 18 | 5 |
| 1 (Ex-ECG → ECHO → CA) | 141 | 153 | - | 92 | 7.6 | 0.012 | 25 | 12 | |
| 9 (CTA → CA) | 197 | 202 | 1420* | 98 | 2.4 | 0.007 | 29 | 12 | |
| 8 (C-MRI → CA) | 315 | 322 | 47 800† | 98 | 2.1 | 0.008 | 37 | 19 | |
| Moderate | 2 (Ex-ECG → CTA → CA) | 188 | 231 | - | 81 | 18.5 | 0.013 | 35 | 3 |
| 4 (Ex-ECG → CA) | 205 | 240 | 415‡ | 86 | 14.3 | 0.017 | 58 | 23 | |
| 9 (CTA → CA) | 269 | 286 | 750§ | 94 | 5.9 | 0.011 | 51 | 7 | |
| 6 (ECHO → CA) | 286 | 305 | - | 94 | 6.4 | 0.017 | 61 | 17 | |
| 8 (C-MRI → CA) | 385 | 407 | 17 800† | 95 | 5.2 | 0.012 | 57 | 12 | |
| High | 4 (Ex-ECG → CA) | 222 | 278 | - | 80 | 20.1 | 0.018 | 63 | 14 |
| 9 (CTA → CA) | 317 | 345 | 790§ | 92 | 8.2 | 0.014 | 66 | 4 | |
| 6 (ECHO → CA) | 320 | 351 | - | 91 | 8.9 | 0.019 | 71 | 10 | |
| 10 (CA → ECHO) | 373 | 381 | 273† | 98 | 1.7 | 0.02 | 100 | 30 |
*ICER vs strategy 1.
†ICER vs strategy 9.
‡ICER vs strategy 2.
§ICER vs strategy 4.
Avg, average; CA, invasive coronary angiography; C-E, cost-effectiveness; C-MRI, cardiac MRI; CTA, CT coronary angiogram; ECHO, stress echocardiogram; Ex-ECG, exercise ECG; FN, false-negative; ICER, incremental cost-effectiveness ratio.