Publications by authors named "R L Akehurst"

Aims: Coronary Computed Tomography Angiography (CCTA) is a first line investigation for chest pain in patients with suspected obstructive coronary artery disease (CAD). However, many acute cardiac events occur in the absence of obstructive CAD. We assessed the lifetime cost-effectiveness of integrating a novel artificial intelligence-enhanced image analysis algorithm (AI-Risk) that stratifies the risk of cardiac events by quantifying coronary inflammation, combined with the extent of coronary artery plaque and clinical risk factors, by analysing images from routine CCTA.

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Background: Resistant hypertension (rHTN) is defined as blood pressure (BP) of ≥ 140/90 mmHg despite treatment with at least three antihypertensive medications, including a diuretic. Endovascular ultrasound renal denervation (uRDN) aims to control BP alongside conventional BP treatment with antihypertensive medication. This analysis assesses the cost effectiveness of the addition of the Paradise uRDN System compared with standard of care alone in patients with rHTN from the perspective of the United Kingdom (UK) health care system.

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Article Synopsis
  • Left atrial appendage closure (LAAC) using the Watchman device is found to be more cost-effective than warfarin and direct oral anticoagulants (DOACs) for stroke prevention in Japanese patients with non-valvular atrial fibrillation (NVAF).
  • A lifetime analysis showed LAAC saves approximately JPY 1,878,335 (about $17,600) compared to warfarin and JPY 1,198,096 (around $11,226) compared to DOACs, while also providing more quality-adjusted life years (QALYs).
  • The study indicates that LAAC is not only less expensive but also offers a better quality of life, making it a favorable
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Objectives: Real-world data (RWD) and real-world evidence (RWE) can provide extensive information on healthcare for use in health technology assessment and decision making. Nevertheless, there is a lack of consensus surrounding the appropriate data governance (DG) practices for RWD/RWE. Data sharing is also a large concern, especially considering evolving data protection regulations.

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