Value of genetic testing in the prevention of coronary heart disease events

dc.contributorAalto-yliopistofi
dc.contributorAalto Universityen
dc.contributor.authorHynninen, Yrjänäen_US
dc.contributor.authorLinna, Miikaen_US
dc.contributor.authorVilkkumaa, Eevaen_US
dc.contributor.departmentDepartment of Mathematics and Systems Analysisen
dc.contributor.departmentDepartment of Industrial Engineering and Managementen
dc.contributor.departmentDepartment of Information and Service Managementen
dc.date.accessioned2019-02-25T08:42:49Z
dc.date.available2019-02-25T08:42:49Z
dc.date.issued2019-01-01en_US
dc.description.abstractBackground: The health economic evidence about the value and optimal targeting of genetic testing in the prevention of coronary heart disease (CHD) events has remained limited and ambiguous. The objective of this study is to optimize the population-level use and targeting of genetic testing alongside traditional risk factors in the prevention of CHD events and, thereby, to assess the cost-benefit of genetic testing. Methods and findings: We compare several strategies for using traditional and genetic testing in the prevention of CHD through statin therapy. The targeting of tests to different patient segments within these strategies is optimized by using a decision-analytic model, in which a patient’s estimated risk of CHD is updated based on test results using Bayesian methods. We adopt the perspective of healthcare sector. The data for the model is exceptionally wide and combined from national healthcare registers, the Finnish Institute for Molecular Medicine, and published literature. Our results suggest that targeting genetic testing in an optimal way to those patients about which traditional risk factors do not provide sufficiently accurate information results in the highest expected net benefit. In particular, compared to the use of traditional risk factors only, the optimal use of genetic testing would decrease the expected costs of an average patient aged 45 years or more by 2.54€ in a 10-year follow-up period while maintaining the level of the expected health outcome. Thus, genetic testing is found to be a part of a cost-beneficial testing strategy alongside traditional risk factors. This conclusion is robust to reasonable changes in model inputs. Conclusions: If targeted optimally, the use of genetic testing alongside traditional risk factors is cost-beneficial in the prevention of CHD.en
dc.description.versionPeer revieweden
dc.format.extent1-16
dc.format.mimetypeapplication/pdfen_US
dc.identifier.citationHynninen, Y, Linna, M & Vilkkumaa, E 2019, ' Value of genetic testing in the prevention of coronary heart disease events ', PloS one, vol. 14, no. 1, e0210010, pp. 1-16 . https://doi.org/10.1371/journal.pone.0210010en
dc.identifier.doi10.1371/journal.pone.0210010en_US
dc.identifier.issn1932-6203
dc.identifier.otherPURE UUID: 26328e92-a1cd-4e94-aca7-56f512837438en_US
dc.identifier.otherPURE ITEMURL: https://research.aalto.fi/en/publications/26328e92-a1cd-4e94-aca7-56f512837438en_US
dc.identifier.otherPURE LINK: http://www.scopus.com/inward/record.url?scp=85060055723&partnerID=8YFLogxKen_US
dc.identifier.otherPURE FILEURL: https://research.aalto.fi/files/31627876/journal.pone.0210010.pdfen_US
dc.identifier.urihttps://aaltodoc.aalto.fi/handle/123456789/36683
dc.identifier.urnURN:NBN:fi:aalto-201902251840
dc.language.isoenen
dc.publisherPUBLIC LIBRARY SCIENCE
dc.relation.ispartofseriesPloS oneen
dc.relation.ispartofseriesVolume 14, issue 1en
dc.rightsopenAccessen
dc.titleValue of genetic testing in the prevention of coronary heart disease eventsen
dc.typeA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessäfi
dc.type.versionpublishedVersion
Files