Comparative Effectiveness of the Core Components of Cardiac Rehabilitation on Mortality and Morbidity: A Systematic Review and Network Meta-Analysis.

A systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) evaluating the core components of cardiac rehabilitation (CR), nutritional counseling (NC), risk factor modification (RFM), psychosocial management (PM), patient education (PE), and exercise training (ET)) was undertaken. Published RCTs were identified from database inception dates to April 2017, and risk of bias assessed using Cochrane's tool. Endpoints included mortality (all-cause and cardiovascular (CV)) and morbidity (fatal and non-fatal myocardial infarction (MI), coronary artery bypass surgery (CABG), percutaneous coronary intervention (PCI), and hospitalization (all-cause and CV)).

The half-cycle correction revisited: redemption of a kludge.

Decision-analytic software commonly used to implement discrete Markov models requires transitions to occur between simulated health states either at the beginning or at the end of each cycle. The result is an over- or underestimation, respectively, of quality-adjusted life expectancy and cost, compared with the results that would be obtained if transitions were modeled to occur randomly throughout each cycle. The standard half-cycle correction (HCC) is used to remedy the bias.