Sensitivity Analysis on Event Rate Parameters—2x MESA Event Rates.

<p>Note: A risk assessment and treatment strategy is said to dominate if it is less costly and more effective than both of the alternative strategies to which it is compared. Otherwise, the favored strategy may be incrementally more costly and more effective than ATP III, which was the standard of risk assessment when this study was conducted. If the incremental cost per unit of effect is less than or equal to $50,000, the alternative intervention is assumed to be favored, and an incremental cost-effectiveness ratio (ICER) is reported. If the ICER exceeds$50,000, but is positive, then ATP III is preferred. Mean costs and effects for each scenario, which are the basis for the decisions summarized in the table, are presented in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0116377#pone.0116377.s004" target="_blank">S3 Table</a>. Scenarios are identified by the scenario number on each row of the table.</p><p>Sensitivity Analysis on Event Rate Parameters—2x MESA Event Rates.</p

Averted CHD and CVD Events Per 1,000 Persons, Base-Case MESA Event Rates.

<p>Note: Simulated events per 1,000 persons, by risk assessment and treatment strategy. The results displayed in this table value outcomes in terms of averted events, but <i>not</i> QALYs. Results reflect all base-case model assumptions and 1x MESA event rates.</p><p>* Column displays results for the scenario where patients with CAC≥1 are advised to initiate statins (intensive therapy for CAC≥100, and standard therapy for 1≤CAC<100).</p><p>Averted CHD and CVD Events Per 1,000 Persons, Base-Case MESA Event Rates.</p

Cost-Effectiveness Acceptability Curves.

<p>Panel (a): 10-Year CVD Events, Treat CAC ≥ 1. Panel (b): 10-Year CVD Events, Treat CAC ≥ 100. Note: The cost-effectiveness acceptability curves show the proportion of simulations (vertical axis) that are cost-effective at a given willingness-to-pay threshold (horizontal axis). A mean CAC scanning cost of $100 and a mean statin cost of$180 is assumed in both plots (indirect costs and costs associated with incidentalomas are not included). The vertical intercept of each cost-effectiveness acceptability curve includes simulations that are cost saving and which result in a loss of fewer QALYs compared to the alternative scenarios. The intercept can be interpreted as the probability that a strategy would be accepted at a willingness-to-pay threshold of $0/QALY. For example, approximately 75$0/QALY threshold.</p

Model Parameters.

<p>Model Parameters.</p

Schematic of the risk assessment and treatment strategies compared.

<p>* Patients with 1≤CAC<100 are advised to initiate standard statin therapy, which is assumed to provide a mean 35% reduction in the relative risk of CVD events. Patients with CAC≥100 are advised to begin intensive therapy, which provides a mean 45% reduction in the relative risk of CVD events.</p