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Table 3 Incremental cost-effectiveness results of included studies by theme

From: A systematic review of cost-effectiveness of treating out of hospital cardiac arrest and the implications for resource-limited health systems

Study

Location

Intervention

Findings per QALY or LY saved (currency standardized to 2022 USD)

CPR and Bystander Training (n = 8)

 Al-Badriyeh 2022 [24]

Qatar

Out-of-hospital extracorporeal cardiopulmonary resuscitation (OH-ECPR) vs in-hospital extracorporeal cardiopulmonary resuscitation (IH-ECPR)

$127,634/ case of success

 Bouland 2015 [30]

US

Large scale community bystander CPR training

$27,012/QALY

 Doan 2022 [34]

Australia

Extracorporeal cardiopulmonary resuscitation (E-CPR) v conventional CPR (C-CPR)

$30,971/QALY

 Groeneveld 2005 [40]

US

CPR only vs CPR + AED (bystanders)

$298,727/QALY general population; $89,724/QALY if trainee lives w/ person > 75

 Marti 2017 [44]

UK

Mechanical CPR

Manual CPR dominates mechanical CPR

 Nichol 2009 [50]

US and Canada

CPR only vs CPR + AED (bystanders)

$78,185/QALY; $48,333/QALY

 Osorio Cuevas 2019 [52]

Colombia

CPR only vs CPR + AED

$1,007/LS

 Vercammen 2020 [63]

Belgium

Smartphone application mobilizing CPR by bystanders

$20,534/QALY

Increasing Access to Automated External Defibrillators (AEDs) (n= 18)

 Andersen 2019 [25]

US

Public Access AEDs

$15,582/QALY

 Bauer 2021 [26]

Germany

AED drone network

$27,749/LYS

 Benson 2022 [28]

England

School-based AEDs vs no AED usage

$11,398/QALY

 Bogle 2019 [29]

US

AED drone network

$11,584/QALY

 Cram 2003 [32]

US

Public Access AEDs

$46,493/QALY

 Cram 2005 [33]

US

In home AEDs to high-risk individuals

$134,280/QALY

 Folke 2009 [35]

Denmark

Public Access AEDs

$42,862/QALY (ERC) or $52,962/QALY (AHA)

 Forrer 2002 [36]

US

Police equipped with AEDs

$86,618/LS or $19,776/LYS

 Foutz 2000 [37]

US

AEDs in long term care facilities

$114,149/ LS

 Groeneveld 2001 [39]

US

AEDs on airlines

$59,074 on aircraft > 200 seats; $68,278 on aircraft > 100 seats; $158,479/QALY on all aircraft

 Haag 2020 [41]

US

In home AEDs to children with HCM

$94,285/QALY

 Mears 2006 [45]

US

Public Access AEDs– rural locations

$15,844/LS or $3,618/LYS

 Moran 2015 [46]

Ireland

Public Access AEDs

$114,798/QALY

 Nichol 1998 [48]

US

Public Access AEDs

$78,185/QALY

 Nichol 2003 [49]

US

Public Access AEDs

$85,913/QALY

 Shaker 2022 [55]

US

Portable SMall AED for Rapid Treatment of SCA (SMART)

Societal: $53,925/QALY; Healthcare: $59,672/QALY

 Sharieff 2007 [56]

Canada

Public Access AEDs

$539,434 Office; $2,487,615 Apartment; $92,303 high risk homes; $1,612,055 homes of high risk > 55

 Walker 2003 [69]

Scotland

AEDs (selectively placed)

$97,962/QALY

Prehospital System Interventions (n= 19)

 Achana 2020 [22]

UK

Adrenaline use

$122,769/QALY

 Aguilera Campos 2012 [23]

Mexico

Increasing ambulances and training police in bystander CPR and AEDs to improve time to CPR/AED

$47,019 to 517,214 / life saved

 Benger 2022 [27]

England

i-gel supraglottic airway (SGA) vs tracheal intubation (TI)

Dominated

 Cappato 2005 [31]

Italy

AEDs added to ambulance system

$35,465/QALY

 Ginsberg 2015 [38]

Israel

Various prehospital interventions (BLS/ALS and ambulance transfer)

$35,776/DALY

 Jakobsson 1987 [42]

Sweden

Advanced EMT defibrillator training (8 h training program to distinguish ventricular tachycardia/ ventricular fibrillation from other rhythms and how to defibrillate expediently)

$36,713/LS

 Jermyn 2000 [43]

Canada

Equipping rural first responder fire departments with AED's

$11,164/LS (urban; control), $81,183/LS (rural; experimental)

 Nichol 1996 [47]

Canada

Various prehospital interventions (improved response time/ambulance defibrillators)

$102,260/QALY

 Ornato 1988 [51]

US

Basic EMT vs EMT trained in defibrillation vs paramedics

$18,116/LS basic EMT; $5,010/ LS EMT trained defibrillation; $5,395/LS paramedic

 Perkins 2021 [53]

UK

Adrenaline use

$2,397,888/QALY first 6 months or $114,824/QALY over lifetime

 Rauner 2003 [54]

Austria

Equipping Austrian Red Cross Ambulances with AED's

$25,840/QALY

 Stokes 2021 [58]

UK

i-gel supraglottic airway (SGA) vs tracheal intubation (TI)

No evidence of difference in cost-effectiveness

 Sund 2012 [59]

Sweden

Early defibrillation by dispatching AEDs with Fire as well as EMS

$18,662/QALY; $86,130/LS

 Urban 1981 [60]

US

Paramedic training/services

$184,320/LS

 Valenzuela 1990 [61]

US

Creation of EMS system for OHCA

$267,423/LS or $19,979/LYS

 van Alem 2004 [62]

Netherlands

Reducing time to shock

$28,619/LS 2 min reduction; $23,381/LS 4 min reduction; $20,773/LS 6 min reduction

Termination of resuscitation (n = 1)

 Shibahashi 2022 [57]

Japan

BLS termination-of-resuscitation (TOR), ALS TOR or no TOR

$23,851/QALY