Prepared by:
Southern California-RAND Evidence-based Practice Center,
Santa Monica, CA
Program Director
Paul Shekelle, M.D., Ph.D.
Program Co-Director
Sally Morton, Ph.D.
Investigator
Col. Sidney Atkinson, M.D.
EPC Staff
Marika Suttorp, M.S.
Wenli Tu, M.S.
Paul Heidenreich, M.D., M.S.
Matthew Gubens, M.P.H.
Margaret Maglione, M.P.P.
Lara Jungvig, B.A.
Elizabeth Roth, M.S.
Sydne Newberry, Ph.D.
File Name Description Software Version File Size ________________________________________________________________________________________________ 01front.doc Microsoft Word® Document MS Word® 2002 99KB 11 pages Contents: Title Page, Preface, Structured Abstract, Table of Contents ________________________________________________________________________________________________ 02summ.doc Microsoft Word® Document MS Word® 2002 106KB 9 pages Contents: Summary: Overview, Reporting the Evidence, Methodology, Findings, Conclusions, Future Research ________________________________________________________________________________________________ 03chap1.doc Microsoft Word® Document MS Word® 2002 59KB 2 pages Contents: Chapter 1. Overview ________________________________________________________________________________________________ 04chap2.doc Microsoft Word® Document MS Word® 2002 131KB 12 pages Contents: Chapter 2. Methodology: Scope of Work, Preliminary Search, Meta-Analysis, Cost-effectiveness Analysis, Peer Review ________________________________________________________________________________________________ 05tbl1.doc Microsoft Word® Document MS Word® 2002 53KB 1 page Contents: Table 1. Search methodology ________________________________________________________________________________________________ 06tbl2&3.doc Microsoft Word® Document MS Word® 2002 71KB 1 page Contents: Table 2. Outcome of requests for subgroup data from principal RCTs of ACE inhibitors and beta-blockers Table 3. Sources of data for meta-analysis from principal RCTs of ACE inhibitors and beta blockers ________________________________________________________________________________________________ 07tbl4.doc Microsoft Word® Document MS Word® 2002 78KB 1 page Contents: Table 4. Cost-effectiveness model variables and values for assessing treatment analysis ________________________________________________________________________________________________ 08tbl5.doc Microsoft Word® Document MS Word® 2002 72KB 1 page Contents: Table 5. Cost-effectiveness model variables and values for assessing screening analysis ________________________________________________________________________________________________ 09fig1.doc Microsoft Word® Document MS Word® 2002 60KB 1 page Contents: Figure 1. Decision tree for assessment of treatment analysis ________________________________________________________________________________________________ 10fig2.doc Microsoft Word® Document MS Word® 2002 62KB 1 page Contents: Figure 2. Decision tree for assessment of screening analysis ________________________________________________________________________________________________ 11chap3.doc Microsoft Word® Document MS Word® 2002 105KB 10 pages Contents: Chapter 3. Results: Description of Evidence, Results of Meta-Analysis, Results of Cost-Effectiveness Analysis ________________________________________________________________________________________________ 12tbl6&7.doc Microsoft Word® Document MS Word® 2002 75KB 1 page Contents: Table 6. Effect of ACE inhibitors on mortality from heart failure in male and female patients (relative risk analysis) Table 7. Effect of ACE inhibitors on mortality from heart failure in male and female patients (hazard ratio analysis) ________________________________________________________________________________________________ 13tbl8&9.doc Microsoft Word® Document MS Word® 2002 62KB 1 page Contents: Table 8. Effect of ACE inhibitors on mortality from heart failure in male and female patients, random-effects pooled estimate Table 9. Number needed to treat (NNT) as a function of risk ratio and population mortality risk ________________________________________________________________________________________________ 14t10&11.doc Microsoft Word® Document MS Word® 2002 73KB 1 page Contents: Table 10. Effect of ACE inhibitors on mortality from heart failure in diabetic and nondiabetic patients (relative risk analysis) Table 11. Effect of ACE inhibitors on mortality from heart failure in diabetic and nondiabetic patients (hazard ratio analysis) ________________________________________________________________________________________________ 15t12&13.doc Microsoft Word® Document MS Word® 2002 64KB 1 page Contents: Table 12. Effect of ACE inhibitors on mortality from heart failure in black and white patients (relative risk analysis) Table 13. Effect of ACE inhibitors on mortality from heart failure in black and white patients (hazard ratio analysis) ________________________________________________________________________________________________ 16t14&15.doc Microsoft Word® Document MS Word® 2002 70KB 1 page Contents: Table 14. Effect of beta-blockers on mortality from heart failure in male and female patients (relative risk analysis) Table 15. Effect of beta-blockers on mortality from heart failure in male and female patients (hazard ratio analysis) ________________________________________________________________________________________________ 17t16&17.doc Microsoft Word® Document MS Word® 2002 64KB 1 page Contents: Table 16. Effect of beta-blockers on mortality from heart failure in diabetic and nondiabetic patients (relative risk analysis) Table 17. Effect of beta-blockers on mortality from heart failure in diabetic and nondiabetic patients (hazard ratio analysis) ________________________________________________________________________________________________ 18t18&19.doc Microsoft Word® Document MS Word® 2002 73KB 1 page Contents: Table 18. Effect of beta-blockers on mortality from heart failure in black and white patients (relative risk analysis) Table 19. Effect of beta-blockers on mortality from heart failure in black and white patients (hazard ratio analysis) ________________________________________________________________________________________________ 19t20&21.doc Microsoft Word® Document MS Word® 2002 67KB 1 page Contents: Table 20. Cost-effectiveness base-case results for assessing treatment analysis Table 21. Cost-effectiveness base-case results for assessing screening analysis ________________________________________________________________________________________________ 20tbl22.doc Microsoft Word® Document MS Word® 2002 63KB 1 page Contents: Table 22. Cost-effectiveness literature review of prevalence of reduced ejection fraction ________________________________________________________________________________________________ 21fig3.doc Microsoft Word® Document MS Word® 2002 74KB 1 page Contents: Figure 3. Flow of literature ________________________________________________________________________________________________ 22fig4&5.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 4. Effect of ACE inhibitors on mortality in male heart failure patients (relative risk analysis) Figure 5. Effect of ACE inhibitors on mortality in female heart failure patients (relative risk analysis) ________________________________________________________________________________________________ 23fig6&7.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 6. Effect of ACE inhibitors on mortality in male heart failure patients (hazard ratio analysis) Figure 7. Effect of ACE inhibitors on mortality in female heart failure patients (hazard ratio analysis) ________________________________________________________________________________________________ 24fig8.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 8. Effect of ACE inhibitors on mortality in male and female heart failure patients (relative risk analysis), random-effects pooled estimate, separately for prevention studies ________________________________________________________________________________________________ 25fig9.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 9. Effect of ACE inhibitors on mortality in male and female heart failure patients (relative risk analysis), random-effects pooled estimate, separately for treatment studies ________________________________________________________________________________________________ 26f10&11.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 10. Effect of ACE inhibitors on mortality in nondiabetic heart failure patients (relative risk analysis) Figure 11. Effect of ACE inhibitors on mortality in diabetic heart failure patients (relative risk analysis) ________________________________________________________________________________________________ 27f12&13.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 12. Effect of ACE inhibitors on mortality in nondiabetic heart failure patients (hazard ratio analysis) Figure 13. Effect of ACE inhibitors on mortality in diabetic heart failure patients (hazard ratio analysis) ________________________________________________________________________________________________ 28f14&15.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 14. Effect of ACE inhibitors on mortality in white/nonblack heart failure patients (relative risk analysis) Figure 15. Effect of ACE inhibitors on mortality in black heart failure patients (relative risk analysis) ________________________________________________________________________________________________ 29f16&17.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 16. Effect of beta-blockers on mortality in male heart failure patients (relative risk analysis) Figure 17. Effect of beta-blockers on mortality in female heart failure patients (relative risk analysis) ________________________________________________________________________________________________ 30f18&19.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 18. Effect of beta-blockers on mortality in male heart failure patients (hazard ratio analysis; without BEST) Figure 19. Effect of beta-blockers on mortality in female heart failure patients (hazard ratio analysis; without BEST) ________________________________________________________________________________________________ 31f20&21.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 20. Effect of beta-blockers on mortality in nondiabetic heart failure patients (relative risk analysis) Figure 21. Effect of beta-blockers on mortality in diabetic heart failure patients (relative risk analysis) ________________________________________________________________________________________________ 32f22&23.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 22. Effect of beta-blockers on mortality in white/nonblack heart failure patients (relative risk analysis; without BEST) Figure 23. Effect of beta-blockers on mortality in black heart failure patients (relative risk analysis; without BEST) ________________________________________________________________________________________________ 33f24&25.doc Microsoft Word® Document MS Word® 2002 52KB 1 page Contents: Figure 24. Effect of beta-blockers on mortality in white/nonblack heart failure patients (hazard ratio analysis; without BEST) Figure 25. Effect of beta-blockers on mortality in black heart failure patients (hazard ratio analysis; without BEST) ________________________________________________________________________________________________ 34fig26.doc Microsoft Word® Document MS Word® 2002 133KB 1 page Contents: Figure 26. Model prediction of expected mortality of asymptomatic patients treated or not treated with ACE inhibitors ________________________________________________________________________________________________ 35fig27.doc Microsoft Word® Document MS Word® 2002 112KB 1 page Contents: Figure 27. Model prediction of expected develompment of symptoms or death in asymptomatic patients treated or not treated with ACE inhibitors ________________________________________________________________________________________________ 36fig28.doc Microsoft Word® Document MS Word® 2002 112KB 1 page Contents: Figure 28. Sensitivity analysis of the effect of ACE inhibitor therapy for preventing death on cost-effectiveness of treatment ________________________________________________________________________________________________ 37fig29.doc Microsoft Word® Document MS Word® 2002 127KB 1 page Contents: Figure 29. Sensitivity analysis of the cost of ACE inhibitor therapy on cost-effectiveness of treatment ________________________________________________________________________________________________ 38fig30.doc Microsoft Word® Document MS Word® 2002 61KB 1 page Contents: Figure 30. Sensitivity analysis of the effect of prevalence on the cost-effectiveness of screening for asymptomatic left ventricular dysfunction ________________________________________________________________________________________________ 39fig31.doc Microsoft Word® Document MS Word® 2002 58KB 1 page Contents: Figure 31. Sensitivity analysis of the effect of BNP test cost on the cost-effectiveness of screening for asymptomatic left ventricular dysfunction ________________________________________________________________________________________________ 40fig32.doc Microsoft Word® Document MS Word® 2002 60KB 1 page Contents: Figure 32. Sensitivity analysis of the effect of BNP test cost on the cost-effectiveness of screening for asymptomatic left ventricular dysfunction: specificity of BNP ________________________________________________________________________________________________ 41fig33.doc Microsoft Word® Document MS Word® 2002 70KB 1 page Contents: Figure 33. Sensitivity analysis of the effect of BNP test cost on the cost-effectiveness of screening for asymptomatic left ventricular dysfunction ________________________________________________________________________________________________ 42fig34.doc Microsoft Word® Document MS Word® 2002 64KB 1 page Contents: Figure 34. Sensitivity analysis of the effectiveness of treatment on the cost-effectiveness of screening for asymptomatic left ventricular dysfunction ________________________________________________________________________________________________ 43chap4.doc Microsoft Word® Document MS Word® 2002 54KB 2 pages Contents: Chapter 4. Limitations ________________________________________________________________________________________________ 44chap5.doc Microsoft Word® Document MS Word® 2002 54KB 2 pages Contents: Chapter 5. Conclusions: Methodological Conclusions, Clinical Conclusions, Cost-Effectiveness Conclusions ________________________________________________________________________________________________ 45chap6.doc Microsoft Word® Document MS Word® 2002 51KB 1 page Contents: Chapter 6. Future Research ________________________________________________________________________________________________ 46refs.doc Microsoft Word® Document MS Word® 2002 64KB 3 pages Contents: References ________________________________________________________________________________________________ 47etbl1.doc Microsoft Word® Document MS Word® 2002 135KB 5 pages Contents: Evidence Table 1. ACE Inhibitor-Accepted Articles ________________________________________________________________________________________________ 48etbl2.doc Microsoft Word® Document MS Word® 2002 126KB 4 pages Contents: Evidence Table 2. Beta-Blocker-Accepted Articles ________________________________________________________________________________________________ 49etbl3.doc Microsoft Word® Document MS Word® 2002 76KB 2 pages Contents: Evidence Table 3. ACE Inhibitor Studies Contribituing to the Meta-Analysis ________________________________________________________________________________________________ 50etbl4.doc Microsoft Word® Document MS Word® 2002 63KB 1 page Contents: Evidence Table 4. Beta-Blocker Studies Contributing to the Meta-Analysis ________________________________________________________________________________________________ 51biblio.doc Microsoft Word® Document MS Word® 2002 262KB 28 pages Contents: Bibliography ________________________________________________________________________________________________ 52appa.doc Microsoft Word® Document MS Word® 2002 31KB 3 pages Contents: Appendix A. Data Request Letter ________________________________________________________________________________________________ 53appb.doc Microsoft Word® Document MS Word® 2002 106KB 4 pages Contents: Appendix B. CHF Screener, CHF Quality Review Form ________________________________________________________________________________________________ 54appc.doc Microsoft Word® Document MS Word® 2002 31KB 5 pages Contents: Appendix C. Peer Review Request Letter ________________________________________________________________________________________________ 55appd.doc Microsoft Word® Document MS Word® 2002 197KB 18 pages Contents: Appendix D. Table of Reviewers' Comments and Author's Reponses to Comments by Section of the Evidence report ________________________________________________________________________________________________
AHRQ Publication No. 03-E045
Current as of July 2003
Internet Citation:
Pharmacologic Management of Heart Failure and Left Ventricular Systolic Dysfunction: Effect in Female, Black, and Diabetic Patients, and Cost-Effectiveness. File Inventory, Evidence Report/Technology Assessment Number 82. AHRQ Publication No. 03-E045, July 2003. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/hrtflinv.htm
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