This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn.

Treatment and prevention strategies of myocardial infarction.

Treatment, screening.

Cost-effectiveness analysis.

Patients experiencing myocardial infarction and ten year old children.

The study was carried out in the USA.

Price related to 1977.

Review of studies.

Epidemiological cohort model (model of survival and disease).

Life years gained.

Direct costs were to the health service and the patients. For the third study these were: One physician visit/year for ten years and six visits to a counsellor, and the cost of modified diet. The incremental cost of unit and other medical services (including myocardial infarction) during added years of life are included. Price information related to 1977.

US dollars ($). In the DH Register of Cost-effectiveness Studies, the original results were converted to UK pounds sterling () using GDP purchasing power parities and reflated to 1991 using the NHS pay and prices index.

No sensitivity analysis was carried out.

Outcome and cost duration was life long. The incremental cost per life year for: a) Coronary care unit provision on infarction was 4974 (costs and benefits discounted at 5%), and 2889 (costs and benefits not discounted); b) Mobile coronary care unit provision for patients experiencing myocardial infarction was 6988 (costs and benefits discounted at 5%), and 5092 (costs and benefits not discounted); c) Screening of serum cholesterol in ten year old children was 15160 (costs and benefits discounted at 5%), and 3957 (costs and benefits not discounted).

(This commentary was not written by CRD, but by the authors of the DH Register.)

It is unknown whether high risk individuals with diet-lowered serum cholesterol receive all the additional life-expectancy of those with naturally lower levels.