| Description | Mean (95% CI) | Distribution (parameter 1, parameter 2) for PSA | Reference |
|---|---|---|---|
| Efficacy of treatment at 90 d post-AIS | |||
| IVT alone strategy, % | |||
| All-cause mortality | 17.86 (13.89-21.82) | β (64.03, 294.50) | 10-14 |
| Functional independence | 28.74 (21.80-35.67) | β (46.68, 115.75) | 10-14 |
| MT plus IVT strategy | |||
| All-cause mortality, % | 17.86 (13.89-21.82) | β (64.03, 294.50) | 10-14 |
| Odds ratio of functional independence, MT plus IVT v. IVT alone* | 2.39 (1.88-3.04) | Log-normal (0.8713, 0.1226) | 10-14 |
| Difference in health utility relative to IVT | 0.0735 (0.0137-0.1333) | Normal (0.0735, 0.0305) | 10,12 |
| Calibrated monthly transition probabilities of natural history for > 3 mo after stroke | Best fitting parameter set | 1000 convergent parameter sets | |
| From functional independence to disability, mo | |||
| 4-6 | 0.0321 | - | 17,18,20,21 |
| 7-12 | 0.0220 | - | 17,18,20,21 |
| 13-24 | 0.0134 | - | 17,18,20,21 |
| 25-36 | 0.0111 | - | 17,18,20,21 |
| 37-48 | 0.0093 | - | 17,18,20,21 |
| 49-60 | 0.0077 | - | 17,18,20,21 |
| From disability to functional independence, mo | |||
| 4-6 | 0.0372 | - | 20 |
| 7-12 | 0.0156 | - | 20 |
| 13-60 | 0 | - | Assumption** |
| From functional independence to death, mo | |||
| 4-12 | 0.0080 | - | 17,18,20,21 |
| 13-24 | 0.0034 | - | 17,18,20,21 |
| 25-36 | 0.0039 | - | 17,18,20,21 |
| 37-48 | 0.0043 | - | 17,18,20,21 |
| 49-60 | 0.0047 | - | 17,18,20,21 |
| From disability to death, mo | |||
| 4-12 | 0.0229 | - | 17,18,20,21 |
| 13-24 | 0.0096 | - | 17,18,20,21 |
| 25-36 | 0.0108 | - | 17,18,20,21 |
| 37-48 | 0.0122 | - | 17,18,20,21 |
| 49-60 | 0.0131 | - | 17,18,20,21 |
| Health care costs, $CAD† | |||
| First 3 mo after stroke | |||
| Extra cost of MT treatment | 15 000 | γ (25, 600) | 22-28 |
| Functional independence (mRS of 0-2) | 18 852 | γ (25, 754.08) | 29 |
| Disability (mRS of 3-6) | 57 382 | γ (25, 2295.28) | 29 |
| IVT alone, weighted by health status‡ | 46 308 | - | 22-29 |
| MT + IVT, weighted by health status§ | 53 471 | - | 22-29 |
| Greater than 3 mo after stroke | |||
| Functional independence (mRS of 0-2) | 1 384 per month | γ (25, 55.36) | 29 |
| Disability (mRS of 3-5) | 3 080 per month | γ (25, 123.2) | 29 |
| Health utility for > 3 mo after stroke | |||
| Functional independence (mRS of 0-2) | 0.71 (0.68-0.74) | β (623.29, 254.58) | 30 |
| Disability (mRS of 3-5) | 0.31 (0.29-0.34) | β (407.26, 906.49) | 30 |
Note: AIS = acute ischemic stroke, $CAD = Canadian dollars in 2015, CI = confidence interval, IVT = intravenous thrombolysis, mRS = modified Rankin Scale, MT = mechanical thrombectomy, PSA = probabilistic sensitivity analysis.
*Given the odds ratio of 2.39 and pooled proportion of functional independence of 0.2874, we estimated that the proportion of functional independence was 0.4908.
†Economic Burden of Ischemic Stroke study29 did not report the 95% CI or standard error (SE) of their cost estimates. We assumed the SE was equal to 20% of the mean in the probabilistic sensitivity analysis.
‡$18 852 × 0.2874 + $57 382 × 0.7126 = $46 308.
§$15 000 + $18 852 × 0.4908 + $57 382 × 0.5092 = $53 471.
¶Unless stated otherwise. **Evidence suggests that the chance of patients recovering from disability to functional independence after 1 yr after acute stroke is small.20