An educational tool to illustrate cost-effectiveness in diagnostic pathways for - Coronary artery disease

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.