Study on health economics eevaluation of diagnostic strategy of coronary heart disease

Sun Yuxin; Xia Qing; Zhan Haoran; Han Youli; Xu Tingting

doi:10.3969/j.issn.1674-4055.2025.03.05

Abstract：Objective To sort out the research status of health economic evaluation of coronary atherosclerotic heart disease(CHD)diagnosis strategy,and provide economic basis for optimizing the diagnosis strategy of CHD in China.Methods In this study,the literature on health economics evaluation of coronary heart disease diagnosis strategies published by December 31st,2021 in PubMed,Scopus,Embase,China Knowledge Network and Wanfang Data Knowledge Service Platform were retrieved by systematic review.Analyze the quality,basic information and content of the included documents.Results This study was screened by title,abstract and full text,and finally 69 studies were included.The number of health economic evaluation of Coronary Angiography(CAG),Computed Tomography Angiography(CTA),blood flow reserve fraction and noninvasive coronary blood flow reserve fraction derived from CT images accounted for nearly 50%(33 articles,47.8%)of the total research,among which 14 articles did not report the research angle;Only 7 studies were discounted in cost and/or effect,and 64%of the studies were of lower-middle quality.The conclusion of social research suggests that CTA is more cost-effective and consistent than CAG in early screening.Adding functional diagnosis before invasive diagnosis and surgical treatment has economic advantages in cost-effectiveness and cost-effectiveness.Conclusion At present,the research on economic evaluation of coronary heart disease diagnosis strategy is generally insufficient,with poor quality,single research perspective and short-term evaluation.The cost evaluation is limited to the direct medical cost and lacks the evidence of long-term economic benefits.