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Table 1 Average cost of diagnostic exams per patient with syncope

From: Financial impact of adopting implantable loop recorder diagnostic for unexplained syncope compared with conventional diagnostic pathway in Portugal

Investigations [21] Unit prices Sousa Pedro [24] Edvardsson [21] Baron-Esquivias [7] Brignole [4] Farwell [16] Unit prices reference [25]
Percentage of patients Weighted value Percentage of patients Weighted value Percentage of patients Weighted value Percentage of patients Weighted value Percentage of patients Weighted value  
Standard electrocardiogram 6.50€ 100% 6.50€ 98% 6.37€ 95,6% 6.21€ 100% 6.50€ - - Code 40301
Echocardiography 53.20€ 72.2% 38.41€ 86% 45.75€ 2,1% 1.12€ 16% 8.51€ 15.31% 8.14€ Code 40550
Overload echocardiography 85.30€ 1.60% 1.36€   - - -   -   - Code 40550;40315
Abdominal echography 20.12€ - - - - - - 2% 0.40€ - - Code 17130
Basic laboratory tests   - -        - - Pack Estimationa
With/enzymes tests 65.87€    86% 56.65€    35% 23.05€  
Without enzymes tests 53.87€      70,2% 37.82€    
Enzymesb 34.40€ - - - - 30,2% 10.39€ - - - - Pack Estimationb
Ambulatory ECG monitoring 43.70€ - - 67% 29.28€ - -    11.22% 4.91€ Code 40405
ELR 47.30€ - - - - - - - - 28.57% 13.51€  
In-Hospital ECG monitoring 124.70€ 61.20% 76.32€ 55% 68.59€ 17,1% 21.32€ 11% 13.72€ - - Code 40495 + daily admission (85€)
Exercise testing 32.10€ 19.60% 6.29€ 52% 16.69€ - - 3% 0.96€ - - Code 40315
MRI or CT scan 97.45€ 1.60% 1.56€ 47% 45.80€ - - 15% 14.62€ - - Codes 18010; 16010
MRI 127.90€ - - - - - - - - 1.02% 1.31€ Code 18010
Brain CT scan 67.00€ - - - - 9% 6.03€ - - 8.16% 5.47€ Code 16010
Thorax CT scan 74.70€ - - - - 1,1% 0.82€ - - - - Code 16060
Chest X-ray 9.00€ - - - - 51,9% 4.67€ 12% 1.08€ - - Code 10406
Electroencephalography 58.80€ 1.20% 0.71€ 39% 22.93€ - - 6% 3.53€ 2.04% 1.20€ Code 63010
Carotid sinus massage 6.50€ 2.90% 0.19€ 36% 2.34€ 0,5% 0.03€ 15% 0.98€ - - Code 40301
Carotid echo-doppler 23.17€ 12.70% 2.94€ - - - - 4% 0.93€ 5.10% 1.18€ Code 17290
TILT test 124.10€ 15.90% 19.73€ 35% 43.44€ - - 13% 16.13€ - - Code 41120
Electrophysiology testing 2,488.72€ - - 25% 622.18€ - - 3% 74.66€ 1.02% 25.40€ Code 40950
Coronary angiography 531.44€ - - 23% 122.23€ - - 2% 10.63€ - - Code 40820
External loop recording 47.30€ 11.80% 5.58€ 12% 5.68€ - - - - - - Code 40479
Orthostatic blood pressure movements 4.00€ - - 48% 1.92€ 4,6% 0.18€ - - - - Code 99230
Hypertension map 59.20€ 6.90% 4.08€ - - - - - - - - Code 41010
Neurological or psychiatric evaluation 30.90€ - - 47% 14.52€ - - - - - - Code 82040
Adenosine Triphosphate (ATP) test Not available - - 3% - - - - - - - Not considered
Others - - - 9% - 7,20% - 13% - - - Not considered
Total cost - - 164.32€ - 1,112.02€   88.51€ - 173.31€ - 72.41€  
  1. aBasic Laboratory costs were estimated considering a standard pack of analysis: Creatinine, Hemogram with leukocyte formula, urea, capillary blood glucose determination, Ionogram (Na, K, Cl), Proteins (total), Albumin Ultra-sensitive C-reactive protein, Summary analysis of Urine, acid-base balance (pH, pCO2, pO2, SatO2, CO2), D- Dimer (DD); and prothrombin time (TP, Quick, INR), (with or without: Troponin T or I, alanine aminotransferase (ALT), aspartate aminotransferase (AST)).
  2. bEnzymes tests: Troponin T or I, Creatine kinase (CK), Myoglobin (Mb), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactic dehydrogenase (LDH).
  3. Costs were taken from the Portuguese National Health Service Prices Table [25].
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