Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation
Article Abstract:
The anticoagulant warfarin is cost-effective in preventing stroke in people with nonvalvular atrial fibrillation but only in those at high risk of stroke. Nonvalvular atrial fibrillation is a heart arrhythmia that affects over 2 million Americans. If the rapidly beating heart throws off a blood clot, the clot could travel to the brain and cause a stroke. Researchers used decision analysis to determine the cost effectiveness of warfarin, aspirin or no treatment for 65-year-old people with atrial fibrillation, and whether the two drugs prolonged life expectancy. In high-risk patients, the quality-adjusted life expectancy over 10 years was 6.51 in those taking warfarin, 6.27 in those taking aspirin and 6.01 years in those not treated. Although warfarin is more expensive than aspirin, it saved money in stroke treatment costs. In low-risk patients, the quality-adjusted life expectancy was similar in those taking warfarin and aspirin and warfarin was less cost-effective than aspirin.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1995
User Contributions:
Comment about this article or add new information about this topic:
A meta-analytic evaluation of the polymerase chain reaction for the diagnosis of HIV infection in infants
Article Abstract:
Physicians should be cautious in interpreting the results of polymerase chain reaction (PCR) testing in newborn infants of mothers with HIV infection. PCR testing is used in newborn infants because it directly detects viral DNA rather than antibodies to the virus, which could have come from the mother. Researchers used meta-analysis to evaluate 32 studies of PCR testing for HIV infection in newborn infants. The sensitivity of the tests ranged from 31% to 100% and the specificity ranged from 50% to 100%. Some studies reported false-positive and false-negative rates as high as 6.7% in newborn infants. However, the rate of false positives and false negatives dropped to 1.8% in older infants. It may be necessary to delay the test until the infant is older than one month. Any tests done at birth can also be repeated at this time.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
User Contributions:
Comment about this article or add new information about this topic:
Accuracy of Positron Emission Tomography for Diagnosis of Pulmonary Nodules and Mass Lesions: A Meta-analysis
Article Abstract:
Positron emission tomography (PET) with 18-fluorodeoxyglucose is an effective non-invasive diagnostic test for detecting a mass in the lungs, including those that may be cancerous. This was the conclusion of researchers who analyzed 40 studies of PET scanning to detect lung masses.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2001
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Screening for cardiac disease in patients having noncardiac surgery. Prediction of perioperative risk: the glass may be three-quarters full
- Abstracts: Cost effectiveness of colorectal cancer screening in the elderly. Screening strategies for colorectal cancer
- Abstracts: The effect of thigh-length support stockings in the hemodynamic response to ambulation in pregnancy. Maternal deaths in an urban perinatal network, 1992-1998
- Abstracts: The continuing effectiveness of active management of first labor, despite a doubling in overall nulliparous cesarean delivery
- Abstracts: Risk perception and risk communication: benefits of dentist-patient discussions. Dentists' attitudes and behaviors regarding domestic violence: the need for an effective response