Public Health and Cost Benefits of Successful Reperfusion After Thrombectomy for Stroke.

Aged Aged, 80 and over Cost-Benefit Analysis Female Humans Male Middle Aged Models, Economic Public Health / economics Quality of Life Reperfusion Stroke / economics Thrombectomy / economics United States
United States cost savings quality-adjusted life years reperfusion thrombectomy

Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
03 2020
Historique:
pubmed: 23 1 2020
medline: 23 6 2020
entrez: 23 1 2020
Statut: ppublish

Résumé

Background and Purpose- The benefit that endovascular thrombectomy offers to patients with stroke with large vessel occlusions depends strongly on reperfusion grade as defined by the expanded Thrombolysis in Cerebral Infarction (eTICI) scale. Our aim was to determine the lifetime health and cost consequences of the quality of reperfusion for patients, healthcare systems, and society. Methods- A Markov model estimated lifetime quality-adjusted life years (QALY) and lifetime costs of endovascular thrombectomy-treated patients with stroke based on eTICI grades. The analysis was performed over a lifetime horizon in a United States setting, adopting healthcare and societal perspectives. The reference case analysis was conducted for stroke at 65 years of age. National health and cost consequences of improved eTICI 2c/3 reperfusion rates were estimated. Input parameters were based on best available evidence. Results- Lifetime QALYs increased for every grade of improved reperfusion (median QALYs for eTICI 0/1: 2.62; eTICI 2a: 3.46; eTICI 2b: 5.42; eTICI 2c: 5.99; eTICI 3: 6.73). Achieving eTICI 3 over eTICI 2b reperfusion resulted on average in 1.31 incremental QALYs as well as healthcare and societal cost savings of $10 327 and $20 224 per patient. A 10% increase in the eTICI 2c/3 reperfusion rate of all annually endovascular thrombectomy-treated patients with stroke in the United States is estimated to yield additional 3656 QALYs and save $21.0 million and $36.8 million for the healthcare system and society, respectively. Conclusions- Improved reperfusion grants patients with stroke additional QALYs and leads to long-term cost savings. Procedural strategies to achieve complete reperfusion should be assessed for safety and feasibility, even when initial reperfusion seems to be adequate.

Identifiants

DOI: 10.1161/STROKEAHA.119.027874 PMID: 31964289
pubmed: 31964289
doi: 10.1161/STROKEAHA.119.027874
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

899-907

Commentaires et corrections

Type : CommentIn

Auteurs

Wolfgang G Kunz (WG)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Mohammed A Almekhlafi (MA)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Bijoy K Menon (BK)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Jeffrey L Saver (JL)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Myriam G Hunink (MG)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Diederik W J Dippel (DWJ)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Charles B L M Majoie (CBLM)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

David S Liebeskind (DS)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Tudor G Jovin (TG)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Antoni Davalos (A)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Serge Bracard (S)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Francis Guillemin (F)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Bruce C V Campbell (BCV)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Peter J Mitchell (PJ)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Philip White (P)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Keith W Muir (KW)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Scott Brown (S)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Andrew M Demchuk (AM)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Michael D Hill (MD)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

Mayank Goyal (M)

From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).
From the University of Calgary, Alberta, Canada (W.G.K., M.A.A., B.K.M., A.M.D., M.D.H., M.G.).
Department of Radiology, University Hospital, LMU Munich, Germany (W.G.K.).
David Geffen School of Medicine, University of California-Los Angeles (J.L.S., D.S.L.).
Harvard T.H. Chan School of Public Health, Boston, MA (M.G.H.).
Erasmus MC, University Medical Center Rotterdam, the Netherlands (M.G.H., D.W.J.D.).
Academic Medical Center, Amsterdam, the Netherlands (C.B.L.M.M.).
University of Pittsburgh Medical Center, PA (T.G.J.).
Hospital Germans Trias i Pujol, Barcelona, Spain (A.D.).
University Hospital of Nancy, France (S. Bracard, F.G.).
University of Melbourne, Australia (B.C.V.C., P.J.M.).
Newcastle University, Newcastle upon Tyne, United Kingdom (P.W.).
University of Glasgow, United Kingdom (K.W.M.).
Altair Biostatistics, St Louis Park, MN (S. Brown).

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