What is the health economic evidence profile of diagnosing heart failure?
The health economic evidence profile of diagnosing heart failure includes a study by Monahan, which was directly applicable with potentially serious limitations. The study was a cost-utility analysis using a decision tree to categorize patients according to diagnosis. It was conducted on primary care patients aged 55 years or over presenting to GP with symptoms suggestive of HF recruited across 28 central England practices in the UK. The interventions studied were the MICE clinical decision rule with upper and lower cut-off guideline recommended strategies, and echo all. Sensitivity analysis showed that Intervention 3 is the optimal strategy at 99.9%, and remains the most cost effective strategy in a number of scenario analyses. However, when the proportion of HF-REF is 100%, Intervention 1 became the most cost effective strategy.