Table 1.
Base-case values and sources of model input parameters
| Model input | Base-case value* | Distribution | Source | |
|---|---|---|---|---|
| Initial probabilities | ||||
| For each health state mRS 0–6 of EVT-treated patients | Discharge mRS distribution for mTICI 0–3 recanalization | Dirichlet | Save ChildS Study Sporns et al. [12] (Figure 2) | |
| For each health state mRS 0–6 of SC-treated patients | Discharge mRS distribution for mTICI 0–2a recanalization | Dirichlet | Save ChildS Study Sporns et al. [12] (Figure 2) | |
| Treatment with IVT | 0.219 | β | Save ChildS Study Sporns et al. [12] | |
| Transition probabilities | ||||
| Pediatric recurrent stroke rate | 0.066 (over first 5 years) | β | Sträter et al. [39] | |
| Adult recurrent stroke rate | Based on cycle age and time since index stroke | β | Pennlert et al. [18] | |
| Annual death rate | 0.000103 (for 11 years old) | β | US Life Table 2017 [44] | |
| Annual death hazard rates for survivors mRS 0/1/2/3/4/5 | 1.53/1.52/2.17/3.18/4.55/6.55 | Log normal | Kunz et al. [38] | |
| After recurrent pediatric stroke | Discharge mRS distribution for mTICI 0–2a recanalization | Dirichlet | Save ChildS Study Sporns et al. [12] | |
| After recurrent adult stroke | 90-day mRS control arm | Dirichlet | HERMES Goyal et al. [2] | |
| Health care costs | ||||
| Costs within first 90 days after stroke for mRS 0/1/2/3/4/5/6 (excluding IVT and EVT) | $8,778/$12,117/$19,031/$23,536/$31,537/$37,674/$8,856 | ɣ | Dawson et al. [21] | |
| Additional cost of IVT treatment | $7,641 | ɣ | NIS 2018 [43] | |
| Additional cost of EVT treatment | $15,977 | ɣ | Shireman et al. [7] | |
| Long-term annual costs after stroke for mRS 0/1/2/3/4/5 | $12,344/$12,711/$14,704/$25,258/$51,104/$75,131 | ɣ | Shireman et al. [7] | |
| Recurrent stroke hospitalization | $25,283 | ɣ | Chambers et al. [32] | |
| Utilities | ||||
| mRS 0/1/2/3/4/5/6 | 1.00/0.91/0.76/0.65/0.33/0.00/0.00 | β | Chaisinanunkul et al. [33] | |
| Societal costs | ||||
| Paid workforce productivity | ||||
| Average annual earnings of employed population | $13,441 (for 18 to 24 years old) | ɣ | US Census Bureau 2018 | |
| Population employment rate | 0.400 (for 18 to 19 years old) | β | US Bureau of Labor Statistics 2020 | |
| Relative earnings of stroke survivors | 0.825 | β | Vyas et al. [46] | |
| Return-to-work after stroke mRS 0/1/2/3/4/5 | 0.63/0.72/0.49/0.19/0.14/0.00 | β | Tanaka et al. [48] | |
| Unpaid domestic productivity | ||||
| Informal annual caregiving costs | mRS 0–1: $1,650 | ɣ | Hickenbottom et al. [51] | |
| mRS 2–5: $8,253 | ||||
All costs were converted to 2020 USD using the medical care component of the Consumer Price Index.
mRS modified Rankin Scale; EVT, endovascular thrombectomy; mTICI, modified Thrombolysis in Cerebral Infarction; IVT, intravenous thrombolysis; HERMES, Highly Effective Reperfusion evaluated in Multiple Endovascular Stroke Trials; NIS, National Inpatient Sample.
*
The minimum and maximum values for ranges were derived from reported 95% confidence intervals or from calculated 95% confidence intervals with the use of variance estimates as available.