Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial

Abstract Findings from a previous study (ClinicalTrials.gov: NCT05118035) demonstrated that an AI-enabled electrocardiogram (AI-ECG), combining AI reports and physician alerts, effectively identified hospitalized patients at high risk of mortality and reduced all-cause mortality. This study evaluate...

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Main Authors: Ping-Hsuan Hsieh, Chin Lin, Chin-Sheng Lin, Wei-Ting Liu, Tsung-Kun Lin, Dung-Jang Tsai, Yi-Jen Hung, Yuan-Hao Chen, Chih-Yuan Lin, Shih-Hua Lin, Chien-Sung Tsai
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-025-01735-7
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author Ping-Hsuan Hsieh
Chin Lin
Chin-Sheng Lin
Wei-Ting Liu
Tsung-Kun Lin
Dung-Jang Tsai
Yi-Jen Hung
Yuan-Hao Chen
Chih-Yuan Lin
Shih-Hua Lin
Chien-Sung Tsai
author_facet Ping-Hsuan Hsieh
Chin Lin
Chin-Sheng Lin
Wei-Ting Liu
Tsung-Kun Lin
Dung-Jang Tsai
Yi-Jen Hung
Yuan-Hao Chen
Chih-Yuan Lin
Shih-Hua Lin
Chien-Sung Tsai
author_sort Ping-Hsuan Hsieh
collection DOAJ
description Abstract Findings from a previous study (ClinicalTrials.gov: NCT05118035) demonstrated that an AI-enabled electrocardiogram (AI-ECG), combining AI reports and physician alerts, effectively identified hospitalized patients at high risk of mortality and reduced all-cause mortality. This study evaluates its cost-effectiveness from the health payer’s perspective in Taiwan over a 90-day post-intervention period. Cost data were obtained from electronic health records of participating hospitals, and incremental cost-effectiveness ratios (ICERs) per death averted were calculated. Non-parametric bootstrap techniques were used to address uncertainty. Among 15,965 patients, 90-day all-cause mortality was 3.6% in the intervention group versus 4.3% in controls. Medication and ICU costs were higher in the AI-ECG group, but overall medical cost was similar ($6204 vs. $5803). The ICER was $59,500 (95% CI: $-4657 to $385,950) per death averted. The cost-effectiveness acceptability curve showed that 95% of the probability mass lies below a willingness-to-pay threshold of $409,321, supporting favorable cost-effectiveness despite uncertainty.
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issn 2398-6352
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spelling doaj-art-989321b9e4ca42ffb66abb65cd1b89ee2025-08-20T03:21:02ZengNature Portfolionpj Digital Medicine2398-63522025-06-01811710.1038/s41746-025-01735-7Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trialPing-Hsuan Hsieh0Chin Lin1Chin-Sheng Lin2Wei-Ting Liu3Tsung-Kun Lin4Dung-Jang Tsai5Yi-Jen Hung6Yuan-Hao Chen7Chih-Yuan Lin8Shih-Hua Lin9Chien-Sung Tsai10School of Pharmacy, National Defense Medical CenterSchool of Medicine, National Defense Medical CenterDivision of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterDivision of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterDepartment of Pharmacy Practice, Tri-Service General HospitalSchool of Medicine, National Defense Medical CenterDivision of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterDepartment of Neurological Surgery, Tri-Service General Hospital, National Defense Medical CenterDivision of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical CenterDivision of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical CenterDivision of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical CenterAbstract Findings from a previous study (ClinicalTrials.gov: NCT05118035) demonstrated that an AI-enabled electrocardiogram (AI-ECG), combining AI reports and physician alerts, effectively identified hospitalized patients at high risk of mortality and reduced all-cause mortality. This study evaluates its cost-effectiveness from the health payer’s perspective in Taiwan over a 90-day post-intervention period. Cost data were obtained from electronic health records of participating hospitals, and incremental cost-effectiveness ratios (ICERs) per death averted were calculated. Non-parametric bootstrap techniques were used to address uncertainty. Among 15,965 patients, 90-day all-cause mortality was 3.6% in the intervention group versus 4.3% in controls. Medication and ICU costs were higher in the AI-ECG group, but overall medical cost was similar ($6204 vs. $5803). The ICER was $59,500 (95% CI: $-4657 to $385,950) per death averted. The cost-effectiveness acceptability curve showed that 95% of the probability mass lies below a willingness-to-pay threshold of $409,321, supporting favorable cost-effectiveness despite uncertainty.https://doi.org/10.1038/s41746-025-01735-7
spellingShingle Ping-Hsuan Hsieh
Chin Lin
Chin-Sheng Lin
Wei-Ting Liu
Tsung-Kun Lin
Dung-Jang Tsai
Yi-Jen Hung
Yuan-Hao Chen
Chih-Yuan Lin
Shih-Hua Lin
Chien-Sung Tsai
Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial
npj Digital Medicine
title Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial
title_full Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial
title_fullStr Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial
title_full_unstemmed Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial
title_short Economic analysis of an AI-enabled ECG alert system: impact on mortality outcomes from a pragmatic randomized trial
title_sort economic analysis of an ai enabled ecg alert system impact on mortality outcomes from a pragmatic randomized trial
url https://doi.org/10.1038/s41746-025-01735-7
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