Economic Analysis of a Randomized Trial of Biventricular Pacing in Canada
Bibliographic record
Abstract
BACKGROUND: Congestive heart failure (CHF) has been shown to affect 5% of the Canadian adult population, and leads to 9.5 deaths per 100 cardiac-related hospitalizations in Canada. The economic outcomes from biventricular pacing for heart failure are not well understood. This study analyzes resource utilization and related costs associated with CHF for patients who receive standard implantable cardiac defibrillators (ICDs) versus those who receive ICD plus biventricular pacing or cardiac resynchronization therapy (CRT). METHODS: The Canadian analysis of resynchronization therapy in heart failure (CART-HF) study included 72 patients with New York Heart Association class II-IV CHF requiring an ICD. Patients were randomized to receive either ICD + CRT treatment or ICD treatment alone. Medical resource utilization data were collected for 6 months following treatment and were applied to representative costs for the provinces of Quebec and Ontario. Resource utilization was subcategorized into pharmacological therapy, physician visits, hospitalizations, adverse events, and productivity losses. RESULTS: Post-treatment, per patient costs for the CRT + ICD treatment group were less than the follow-up costs for patients receiving ICD treatment only in each province. Mean savings for patients receiving biventricular therapy were CAD 2,420 dollars in Quebec and CAD 2,085 dollars in Ontario during the 6-month follow-up. CONCLUSIONS: These analyses indicate that savings in post-implant health-care utilization (hospitalizations and pharmacological therapy) can offset some of the device and procedural costs associated with CRT devices.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".