Use of an intravenous contrast agent (Optison(TM)) to enhance echocardiography

Efficacy and cost implications

Leslee J. Shaw, Linda Gillam, Steven Feinstein, John Dent, Gary Plotnick

Research output: Contribution to journalReview article

29 Citations (Scopus)

Abstract

Objective: To compare the overall diagnostic costs associated with non- contrast and contrast echocardiography. Study Design: Phase III clinical trial. Patients and Methods: In a secondary analysis of data from a phase III clinical trial of the intravenous contrast agent Optison(TM), we compared the costs associated with obtaining a diagnosis in 203 patients who underwent non-contrast and contrast echocardiography. Costs for the initial test and any follow-up tests were derived from adjusted Medicare charges and a transition-1 microcost accounting system. Results: Diagnostic yield from echocardiograms was 87% with the use of Optison (3 mL) and 49% when no contrast agent was used (P < 0.001). Because technically inadequate echocardiograms were more common in the non-contrast group, follow-up testing was recommended for 42% of patients in this group compared with 12% of those who had undergone a contrast-enhanced echocardiogram (P < 0.001). Although use of Optison increased the initial diagnostic cost by $125, overall costs were 17% lower when Optison was used (P < 0.0001). Use of Optison also resulted in a 17% to 70% decrease in confirmatory transesophageal echocardiography, catheterization, and nuclear studies. Optison improved diagnostic accuracy by 2.7-fold in patients with an initial non-diagnostic echocardiogram, resulting in a substantial cost savings of $269 per patient. Conclusions: Use of Optison may improve the effectiveness of echocardiography and decrease the overall costs of obtaining an accurate diagnosis.

Original languageEnglish (US)
JournalAmerican Journal of Managed Care
Volume4
Issue numberSPEC. ISS. SEPT.
StatePublished - Sep 25 1998

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Contrast Media
Echocardiography
Costs and Cost Analysis
costs
diagnostic
Phase III Clinical Trials
Cost Savings
Transesophageal Echocardiography
secondary analysis
Medicare
FS 069
Catheterization
savings
Group

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Shaw, Leslee J. ; Gillam, Linda ; Feinstein, Steven ; Dent, John ; Plotnick, Gary. / Use of an intravenous contrast agent (Optison(TM)) to enhance echocardiography : Efficacy and cost implications. In: American Journal of Managed Care. 1998 ; Vol. 4, No. SPEC. ISS. SEPT.
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abstract = "Objective: To compare the overall diagnostic costs associated with non- contrast and contrast echocardiography. Study Design: Phase III clinical trial. Patients and Methods: In a secondary analysis of data from a phase III clinical trial of the intravenous contrast agent Optison(TM), we compared the costs associated with obtaining a diagnosis in 203 patients who underwent non-contrast and contrast echocardiography. Costs for the initial test and any follow-up tests were derived from adjusted Medicare charges and a transition-1 microcost accounting system. Results: Diagnostic yield from echocardiograms was 87{\%} with the use of Optison (3 mL) and 49{\%} when no contrast agent was used (P < 0.001). Because technically inadequate echocardiograms were more common in the non-contrast group, follow-up testing was recommended for 42{\%} of patients in this group compared with 12{\%} of those who had undergone a contrast-enhanced echocardiogram (P < 0.001). Although use of Optison increased the initial diagnostic cost by $125, overall costs were 17{\%} lower when Optison was used (P < 0.0001). Use of Optison also resulted in a 17{\%} to 70{\%} decrease in confirmatory transesophageal echocardiography, catheterization, and nuclear studies. Optison improved diagnostic accuracy by 2.7-fold in patients with an initial non-diagnostic echocardiogram, resulting in a substantial cost savings of $269 per patient. Conclusions: Use of Optison may improve the effectiveness of echocardiography and decrease the overall costs of obtaining an accurate diagnosis.",
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Use of an intravenous contrast agent (Optison(TM)) to enhance echocardiography : Efficacy and cost implications. / Shaw, Leslee J.; Gillam, Linda; Feinstein, Steven; Dent, John; Plotnick, Gary.

In: American Journal of Managed Care, Vol. 4, No. SPEC. ISS. SEPT., 25.09.1998.

Research output: Contribution to journalReview article

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AU - Shaw, Leslee J.

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AU - Feinstein, Steven

AU - Dent, John

AU - Plotnick, Gary

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N2 - Objective: To compare the overall diagnostic costs associated with non- contrast and contrast echocardiography. Study Design: Phase III clinical trial. Patients and Methods: In a secondary analysis of data from a phase III clinical trial of the intravenous contrast agent Optison(TM), we compared the costs associated with obtaining a diagnosis in 203 patients who underwent non-contrast and contrast echocardiography. Costs for the initial test and any follow-up tests were derived from adjusted Medicare charges and a transition-1 microcost accounting system. Results: Diagnostic yield from echocardiograms was 87% with the use of Optison (3 mL) and 49% when no contrast agent was used (P < 0.001). Because technically inadequate echocardiograms were more common in the non-contrast group, follow-up testing was recommended for 42% of patients in this group compared with 12% of those who had undergone a contrast-enhanced echocardiogram (P < 0.001). Although use of Optison increased the initial diagnostic cost by $125, overall costs were 17% lower when Optison was used (P < 0.0001). Use of Optison also resulted in a 17% to 70% decrease in confirmatory transesophageal echocardiography, catheterization, and nuclear studies. Optison improved diagnostic accuracy by 2.7-fold in patients with an initial non-diagnostic echocardiogram, resulting in a substantial cost savings of $269 per patient. Conclusions: Use of Optison may improve the effectiveness of echocardiography and decrease the overall costs of obtaining an accurate diagnosis.

AB - Objective: To compare the overall diagnostic costs associated with non- contrast and contrast echocardiography. Study Design: Phase III clinical trial. Patients and Methods: In a secondary analysis of data from a phase III clinical trial of the intravenous contrast agent Optison(TM), we compared the costs associated with obtaining a diagnosis in 203 patients who underwent non-contrast and contrast echocardiography. Costs for the initial test and any follow-up tests were derived from adjusted Medicare charges and a transition-1 microcost accounting system. Results: Diagnostic yield from echocardiograms was 87% with the use of Optison (3 mL) and 49% when no contrast agent was used (P < 0.001). Because technically inadequate echocardiograms were more common in the non-contrast group, follow-up testing was recommended for 42% of patients in this group compared with 12% of those who had undergone a contrast-enhanced echocardiogram (P < 0.001). Although use of Optison increased the initial diagnostic cost by $125, overall costs were 17% lower when Optison was used (P < 0.0001). Use of Optison also resulted in a 17% to 70% decrease in confirmatory transesophageal echocardiography, catheterization, and nuclear studies. Optison improved diagnostic accuracy by 2.7-fold in patients with an initial non-diagnostic echocardiogram, resulting in a substantial cost savings of $269 per patient. Conclusions: Use of Optison may improve the effectiveness of echocardiography and decrease the overall costs of obtaining an accurate diagnosis.

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