Pb. Jacklin et al., An educational tool to illustrate cost-effectiveness in diagnostic pathways for - Coronary artery disease, M D COMPUT, 17(1), 2000, pp. 49-57
Rapid increases in healthcare costs have led to increased intel est in the
cost-effectiveness of medical interventions, Coronary artery disease is res
ponsible for a significant share of total healthcare spending, and therefor
e economic evaluations of medical procedures to treat the condition are pot
entially very important. We have developed a spreadsheet model as an educat
ional tool that can be used to illustrate cost-effectiveness in the selecti
on of diagnostic pathways (a "work-up" strategy of tests designed to reach
a final diagnosis) for coronary artery disease. The model, in Microsoft Exc
el, is easy to use, requiring no specialist computer knowledge. It is menu-
driven and the user navigates the model via a number of on-screen buttons,
A data entry screen allows the user to customize the data For the kev model
parameters, making it possible to take into account location-specific feat
ures. The data entry screen also allows the user to undertake sensitivity a
nalysis and rate "what if" scenarios. The model demonstrates how sensitive
the cost-effectiveness of different diagnostic pathways is to the pretest p
robability of disease. This package could also br used as a decision suppor
t tool, although it is important to recognize some of its limitations for t
his purpose.