@misc{RauchDavosDohertyetal.2016,
  author    = {Rauch, Bernhard and Davos, Constantinos H. and Doherty, Patrick and Saure, Daniel and Metzendorf, Maria-Inti and Salzwedel, Annett and V{\"o}ller, Heinz and Jensen, Katrin and Schmid, Jean-Paul},
  title     = {The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {418},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-405346},
  pages     = {26},
  year      = {2016},
  abstract  = {Background The prognostic effect of multi-component cardiac rehabilitation (CR) in the modern era of statins and acute revascularisation remains controversial. Focusing on actual clinical practice, the aim was to evaluate the effect of CR on total mortality and other clinical endpoints after an acute coronary event. Design Structured review and meta-analysis. Methods Randomised controlled trials (RCTs), retrospective controlled cohort studies (rCCSs) and prospective controlled cohort studies (pCCSs) evaluating patients after acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) or mixed populations with coronary artery disease (CAD) were included, provided the index event was in 1995 or later. Results Out of n=18,534 abstracts, 25 studies were identified for final evaluation (RCT: n=1; pCCS: n=7; rCCS: n=17), including n=219,702 patients (after ACS: n=46,338; after CABG: n=14,583; mixed populations: n=158,781; mean follow-up: 40 months). Heterogeneity in design, biometrical assessment of results and potential confounders was evident. CCSs evaluating ACS patients showed a significantly reduced mortality for CR participants (pCCS: hazard ratio (HR) 0.37, 95\% confidence interval (CI) 0.20-0.69; rCCS: HR 0.64, 95\% CI 0.49-0.84; odds ratio 0.20, 95\% CI 0.08-0.48), but the single RCT fulfilling Cardiac Rehabilitation Outcome Study (CROS) inclusion criteria showed neutral results. CR participation was also associated with reduced mortality after CABG (rCCS: HR 0.62, 95\% CI 0.54-0.70) and in mixed CAD populations. Conclusions CR participation after ACS and CABG is associated with reduced mortality even in the modern era of CAD treatment. However, the heterogeneity of study designs and CR programmes highlights the need for defining internationally accepted standards in CR delivery and scientific evaluation.},
  language  = {en}
}
@misc{BoldtLeberBonaventuraetal.2013,
  author    = {Boldt, Julia and Leber, Alexander W. and Bonaventura, Klaus and Sohns, Christian and Stula, Martin and Huppertz, Alexander and Haverkamp, Wilhelm and Dorenkamp, Marc},
  title     = {Cost-effectiveness of cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary artery disease in Germany},
  series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe},
  number    = {551},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-43010},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-430107},
  pages     = {11},
  year      = {2013},
  abstract  = {Background: Recent studies have demonstrated a superior diagnostic accuracy of cardiovascular magnetic resonance (CMR) for the detection of coronary artery disease (CAD). We aimed to determine the comparative cost-effectiveness of CMR versus single-photon emission computed tomography (SPECT). Methods: Based on Bayes' theorem, a mathematical model was developed to compare the cost-effectiveness and utility of CMR with SPECT in patients with suspected CAD. Invasive coronary angiography served as the standard of reference. Effectiveness was defined as the accurate detection of CAD, and utility as the number of quality-adjusted life-years (QALYs) gained. Model input parameters were derived from the literature, and the cost analysis was conducted from a German health care payer's perspective. Extensive sensitivity analyses were performed. Results: Reimbursement fees represented only a minor fraction of the total costs incurred by a diagnostic strategy. Increases in the prevalence of CAD were generally associated with improved cost-effectiveness and decreased costs per utility unit (Delta QALY). By comparison, CMR was consistently more cost-effective than SPECT, and showed lower costs per QALY gained. Given a CAD prevalence of 0.50, CMR was associated with total costs of (sic)6,120 for one patient correctly diagnosed as having CAD and with (sic)2,246 per Delta QALY gained versus (sic)7,065 and (sic)2,931 for SPECT, respectively. Above a threshold value of CAD prevalence of 0.60, proceeding directly to invasive angiography was the most cost-effective approach. Conclusions: In patients with low to intermediate CAD probabilities, CMR is more cost-effective than SPECT. Moreover, lower costs per utility unit indicate a superior clinical utility of CMR.},
  language  = {en}
}