Chloral hydrate is an appropriate sedation option for pediatric patients in MRI services when strict patient selection criteria are met. The use of a reduced dose does not affect the effectiveness of sedation. The lack of data regarding the presence of transient oxygen desaturation, the time to induce sedation and the exact duration of sedation are limitations of this study.

The 3D DP technique provides as accurate cardiac volumes as the 2D SSFP technique in the pediatric population, but with the added benefits of easier data acquisition and detailed anatomical information of the whole heart and great vessels in a single free-breathing scan.

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OBJECTIVES: to explore the effects of patient self-testing (PST) of oral anticoagulation therapy (OAT) by CoaguChek ® XS System compared to standard available care (laboratory testing) for selected group of patients. METHODS: Health Economy Model (HECON), using Cost-Effectiveness Analysis (CEA), complemented by Budget-Impact Analysis (BIA) on public health insurance coverage in Slovakia. We searched MEDLINE, Cochrane and available grey literature (Industrial Sources and Expert Opinions) for meta analyses, systematic reviews, economic evaluation studies and health technology reports on PST of OAT. Outcomes analyzed were feasibility and accuracy of PST, thromboembolic events, hemorrhagic complications and mortality. Real-world data from General Health Insurance, Inc. were used for costs associated with corresponding diagnoses, complications and management of patients on OAT, including full cohort of patients (nϭ100, average age of 63 years) on PST. Markov Model (life time horizon) for OAT patient management was developed, comparing PST with standard care. Outcomes observed were major thromboembolic events, major hemorrhagic complications and mortality. Payer perspective and direct healthcare costs only, associated with OAT management were considered in CEA and BIA for diagnosis subgroups. Discount rate of 5% was used for costs as well as outcomes. Sensitivity analysis for major complications was performed. RESULTS: CEA for PST vs. standard care associated with OAT shows that intervention is cost-effective (dominant) for all diagnosis subgroups. Net costs (BIA) associated with PST for expanding the existing cohort of patients 10 times (nϭ1000) are 1.596 mil. € in Year 1 (up to 3.579 € in Year 5). CONCLUSIONS: PST of OAT is considered cost-effective in terms of International Normalized Ratio (INR) regulation and safer in terms of complications. Moreover, analysis of selected subpopulations (mitral and/or aortic mechanical heart valve implantation, aortic and/or other aneurysm and congenital cardiovascular malformations) shows that PST brings the most significant cost-savings especially for those OAT patient segments.