Promoting the use of Markovian simulation models to study outcomes of thrombectomy after acute ischemic stroke
Trippoli S, Chiumente M, Messori A
J Cardiovasc Med (Hagerstown)
In patients at risk for acute ischemic stroke (AIS), simulation studies employing Markov models are increasingly being used. In evaluating both preventive and therapeutic interventions for AIS, the AIM of these studies is to determine the ‘typical’ clinical outcomes expected on the long term and to generate estimates of cost-effectiveness. In the filed of treatments for AIS, numerous interventions have been studied in terms of cost-effectiveness including thrombolysis,
endovascular interventions, and -more recently- thrombectomy. In the present report we have tried to facilitate the application of Markov models in the setting of AIS by developing simulation software which is an improved version of the tools previously employed for specific research projects. Our simulation model, that can be downloaded from the following link http://www.osservatorioinnovazione.net/papers/thrombectomy.trex, is designed to be run under TreegePro version 2011 (or subsequent versions). The input variables for the model are shown in the legend to fig. 1. The output of the program is represented by the estimate of total QALYs per patient accrued over the prespecified time horizon. The software manages only the clinical part of these simulations; however, cost data can be added quite easily by introducing new sections of programming.
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