Exhibit 1.
Summary Results for Potential Innovations: Cardiovascular Diseases
| Innovation | Likelihood of occurrence at 20 years |
Brief Summary of Impact |
|---|---|---|
| Improved disease prevention | 40% | 90% reduction in cardiovascular disease. |
| Noninvasive diagnostic imaging to improve risk stratification | Better identification of high risk patients, leading to effective risk reduction strategies. | |
| • General population >45 | 15% | |
| • Subclinical disease | 75% | |
| • Clinical disease | 50% | |
| Magnetic resonance angiography (as a replacement for coronary catheterization) | 100% | Replacement for conventional coronary angiography, likely to increase the number of persons undergoing the procedure. |
| Implantable cardioverter defibrillators for clinical disease | 30–40% | Life expectancy for people with heart failure gets shifted by 6–10 months, 20% now die of some other cause. |
| Left ventricular assist devices (LVAD) | 50% | General increase in function for persons with functional limitations, 50% decrease in heart failure-related hospitalizations, 20% of patients will have improved 1 year mortality. |
| Xenotransplants | 1–3% | Possibly similar to the benefit from human heart transplants, but several experts thought the impact would be lower as the population affected is likely to be different. |
| Therapeutic angiogenesis | Little effect on mortality, decreased number of revascularization procedures by 20–30%. | |
| • Clinical disease: augmentation for revascularization | Currently used | |
| • Clinical disease: replacement for revascularization | 10% | |
| Transmyocardial revascularization | 0–5% | Little effect on mortality, decreased number of revascularization procedures by 20–30%. |
| Pacemaker/defibrillators to control atrial fibrillation | 50% | Decreased stroke by 50% of the attributable fraction due to atrial fibrillation. |
| Catheter-based ablation techniques to control atrial fibrillation | 20% | Decreased stroke by 50% of the attributable fraction due to atrial fibrillation. |
SOURCE: Adapted from D.P. Goldman et al., Health Status and Medical Treatment of the Future Elderly: Final Report, Pub. no. TR-169-CMS (Santa Monica, Calif.: RAND, 2004), Table 3.1.