Table 3.

Cost-effectiveness of distributed training versus conventional training and one-way sensitivity analysis

	Conventional BLS training		Distributed CPR training		Incremental costs	Incremental effectiveness	ICER/interpretation
	Mean cost (CAD)*	Effectiveness	Mean cost (CAD)*	Effectiveness
Base case	$C266.50	0.146	$C224.88	0.543	−$C41.62	+0.397	Distributed training dominates
Sensitive to change of costs
No remediation	$C228.08	0.146	$C204.33	0.543	−$C23.75	+0.397	Distributed training dominates
Training not paid by the hospital	$C106.50	0.146	$C164.88	0.543	+$C58.38	+0.397	$C147.05 per extra excellent CPR provider
No remediation & training not paid by the hospital	$C68.08	0.146	$C144.33	0.543	+$C76.25	+0.397	$C192.07 per extra excellent CPR provider
Least expensive equipment	$C263.24	0.146	$C210.78	0.543	−$C52.46	+0.397	Distributed training dominates
No facilitation for training (assuming self-directed distributed training in achieving the same effectiveness)†	$C266.50	0.146	$C194.88	0.543	−$C71.62	+0.397	Distributed training dominates
Conventional BLS course shortened to 3 hours (removing costs for AED and didactic video time)†	$C226.50	0.146	$C224.88	0.543	−$C1.62	+0.397	Distributed training dominates
Online module time (1 hour) in the distributed CPR group got compensated†	$C266.50	0.146	$C264.88	0.543	−$C1.62	+0.397	Distributed training dominates
Sensitive to effectiveness
All lost-to-follow-ups assumed failure (intention-to-treat)	$C266.50	0.125	$C224.88	0.472	−$C41.62	+0.347	Distributed training dominates
Least effective‡	$C266.50	n/a	$C224.88	n/a	−$C41.62	+0.217	Distributed training dominates

*Mean costs per trainee per year (Canadian dollars in 2016).

†Assuming change of condition will influence cost estimation only, but not the performance of both groups.

‡Incremental effectiveness set as lower bound of 95% CI of base case.

AED, automatic external defibrillator; BLS, basic life support; CPR, cardiopulmonary resuscitation; ICER, incremental cost-effectiveness ratio.