Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, December 29, 2023

Cost-effectiveness of endovascular treatment after 6–24 h in ischaemic stroke patients with collateral flow on CT-angiography: A model-based economic evaluation of the MR CLEAN-LATE trial

What absolute fucking stupidity! Survivors don't care about costs you blithering idiots! They want to know your 100% recovery statistics. GET THERE!

Cost-effectiveness of endovascular treatment after 6–24 h in ischaemic stroke patients with collateral flow on CT-angiography: A model-based economic evaluation of the MR CLEAN-LATE trial

Abstract

Background:

The MR CLEAN-LATE trial has shown that patient selection for endovascular treatment (EVT) in the late window (6–24 h after onset or last-seen-well) based on the presence of collateral flow on CT-angiography is safe and effective.(But does it get  you to 100% recovery? The only goal in stroke?  Or are you so fucking stupid you don't know that?)We aimed to assess the cost-effectiveness of late-window collateral-based EVT-selection compared to best medical management (BMM) over a lifetime horizon (until 95 years of age).

Materials and Methods:

A model-based economic evaluation was performed from a societal perspective in The Netherlands. A decision tree was combined with a state-transition (Markov) model. Health states were defined by the modified Rankin Scale (mRS). Initial probabilities at 3-months post-stroke were based on MR CLEAN-LATE data. Transition probabilities were derived from previous literature. Information on short- and long-term resource use and utilities was obtained from a study using MR CLEAN-LATE and cross-sectional data. All costs are expressed in 2022 euros. Costs and quality-adjusted life years (QALYs) were discounted at a rate of 4% and 1.5%, respectively. The effect of parameter uncertainty was assessed using probabilistic sensitivity analysis (PSA).

Results:

On average, the EVT strategy cost €159,592 (95% CI: €140,830–€180,154) and generated 3.46 QALYs (95% CI: 3.04–3.90) per patient, whereas the costs and QALYs associated with BMM were €149,935 (95% CI: €130,841–€171,776) and 2.88 (95% CI: 2.48–3.29), respectively. The incremental cost-effectiveness ratio per QALY and the incremental net monetary benefit were €16,442 and €19,710, respectively. At a cost-effectiveness threshold of €50,000/QALY, EVT was cost-effective in 87% of replications.

Discussion and Conclusion:

Collateral-based selection for late-window EVT is likely cost-effective from a societal perspective in The Netherlands.
Graphical abstract


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