1.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
2.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
3.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
4.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
5.Interpretation of the definition and diagnostic criteria for pediatric Blepharo-keratoconjunctivitis(2024)
Recent Advances in Ophthalmology 2025;45(11):841-845
Pediatric blepharokeratoconjunctivitis(PBKC)is a chronic condition characterized by recurrent ocular sur-face inflammation,primarily involving the eyelid margins,conjunctiva,and cornea,and predominantly affecting children and adolescents.The longstanding lack of a unified nomenclature,diagnostic criteria,and clinical definition has frequently led to misdiagnosis or delayed treatment,which can potentially result in serious complications such as corneal scarring,visual impairment,and even amblyopia.To enhance clinicians' capability for early identification of this disease,an interna-tional expert panel formulated the consensus titled "Pediatric Blepharokeratoconjunctivitis:Definition and Diagnostic Criteria".This consensus establishes a unified nomenclature,definition,and diagnostic criteria for the disease.Based on the latest clinical research findings,this article provides a systematic interpretation of these criteria,analyzes their implica-tions for clinical practice and future research,and offers important references for subsequent studies and clinical applica-tion.
6.Discussion on curative effect of electronic bronchoscope in treating tracheobronchial tuberculosis at clinical activity stage
Shenglin MO ; Yun HUANG ; Xiaohong HUANG ; Gui TANG ; Yanping SUN ; Jinyu QIN ; Tao CHEN ; Jiaguang HU ; Peng ZHANG ; Jinliang KONG ; Zhongsheng JIANG
China Medical Equipment 2025;22(6):76-80
Objective:To evaluate the clinically curative effect of intervention treatment of electronic bronchoscope in treating tracheobronchial tuberculosis at clinical activity stage.Methods:Sixty patients with tracheobronchial tuberculosis at clinical activity stage(type I,II,III and VI)who admitted to Liuzhou People's Hospital from September 2020 to September 2023 were selected,and they were divided into drug group(anti-tuberculosis drug treatment)and combination group(anti-tuberculosis drug treatment+interventional treatment with electronic bronchoscope)by the random number table method,with 30 cases in each group.The curative effects of the two groups were observed,and the negative conversion rate of sputum bacteria,clinical symptom scores(cough symptom,expectoration symptom)before and after treatment,Modified British Medical Research Council Dyspnea Scale(mMRC)score between two groups were compared,and the differences in indicators of pulmonary function such as forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and maximum voluntary ventilation(MVV)between the two groups also were compared.And then,the incidence of complications was calculated.Results:During the 1,2 and 3 months of follow-up,there were respectively 21 cases,27 cases and 30 cases occurred negative conversion of sputum bacteria in 30 patients of the combination group,and there were respectively 15 cases,18 cases and 23 cases occurred negative conversion of sputum bacteria in 30 patients of the drug group.At the 1st month of follow-up,the negative conversion rate of sputum bacteria in combination group was higher than that in drug group,while there was no statistically significant difference between the two groups(P>0.05).At the 2nd and 3rd month of follow-up,the negative conversion rate of sputum bacteria in the combination group was higher than that in the drug group,and the differences were statistically significant(x2=7.200,7.925,P<0.05).The effective rate of treatment of the combination group was 100%,which was higher than 80%of the drug group,and the difference of that between two groups was significant(x2=6.667,P<0.05).After 2 months of treatment,the mMRC score,cough symptom score and expectoration symptom score of the combination group were all lower than those of the drug group,and the differences were statistically significant(t=3.504,3.950,3.530,P<0.05).The improvement effects of FEV1,FVC and MVV of the combination group were all better than those of the drug group,and the differences were statistically significant(t=6.626,4.966,4.097,P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Anti-tuberculosis drug therapy combined with electronic bronchoscopy intervention has a good therapeutic effect in clinically active tracheobronchial tuberculosis.
7.Efficacy of urapidil combined with nimodipine in treatment of elderly hypertensive intracerebral hemorrhage
Ping YAN ; Jinyu MA ; Chengwang HU ; Xin NIU ; Peng LIU
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(6):762-765
Objective To explore the effect of urapidil combined with nimodipine in the treatment of elderly hypertensive intracerebral hemorrhage(HICH).Methods A total of 128 elderly HICH patients admitted in our hospital from March 2022 to March 2024 were recruited and randomly di-vided into single group(64 cases)and combined group(64 cases).Both groups received routine treatment,and the single group was treated with urapidil while the combined group was given urapidil combined with nimodipine.Clinical efficacy,clinical indicators[cerebral hematoma vol-ume,intracranial pressure(ICP)],neurological function indicators[brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),nerve growth factor(NGF)],hemodynamic pa-rameters[perfusion index(PI),cerebrovascular reserve capacity(CVR),mean bilateral arterial flow velocity],and vascular endothelial function indicators[vascular endothelial growth factor(VEGF),endothelin-1(ET-1),angiopoietin-1(Ang-1)]were compared between the two groups.The incidence of adverse reactions was observed during treatment.Results The total effective rate was significantly higher in the combined group than the single group(89.06%vs 75.00%,P<0.05).After treatment,the ICP,hematoma volume,PI,and levels of NSE,VEGF,ET-1 and Ang-1 in both groups were significantly lower than those before treatment(P<0.05).These indi-cators in the combined group were significantly lower than those in the single group(P<0.05,P<0.01).The CVR,mean bilateral arterial flow velocity,and BDNF and NGF levels were notably increased in both groups after treatment,and the indicators were significantly higher in the com-bined group than the other group(P<0.05,P<0.01).There was no statistical difference in the incidence of adverse reactions between groups(P>0.05).Conclusion Urapidil combined with ni-modipine can shrink the volume of cerebral hematoma,reduce ICP,and improve neurological function,hemodynamics and vascular endothelial function in elderly HICH patients,and the treat-ment does not increase the incidence of adverse reactions.
8.Interpretation of the definition and diagnostic criteria for pediatric Blepharo-keratoconjunctivitis(2024)
Recent Advances in Ophthalmology 2025;45(11):841-845
Pediatric blepharokeratoconjunctivitis(PBKC)is a chronic condition characterized by recurrent ocular sur-face inflammation,primarily involving the eyelid margins,conjunctiva,and cornea,and predominantly affecting children and adolescents.The longstanding lack of a unified nomenclature,diagnostic criteria,and clinical definition has frequently led to misdiagnosis or delayed treatment,which can potentially result in serious complications such as corneal scarring,visual impairment,and even amblyopia.To enhance clinicians' capability for early identification of this disease,an interna-tional expert panel formulated the consensus titled "Pediatric Blepharokeratoconjunctivitis:Definition and Diagnostic Criteria".This consensus establishes a unified nomenclature,definition,and diagnostic criteria for the disease.Based on the latest clinical research findings,this article provides a systematic interpretation of these criteria,analyzes their implica-tions for clinical practice and future research,and offers important references for subsequent studies and clinical applica-tion.
9.Efficacy of urapidil combined with nimodipine in treatment of elderly hypertensive intracerebral hemorrhage
Ping YAN ; Jinyu MA ; Chengwang HU ; Xin NIU ; Peng LIU
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2025;27(6):762-765
Objective To explore the effect of urapidil combined with nimodipine in the treatment of elderly hypertensive intracerebral hemorrhage(HICH).Methods A total of 128 elderly HICH patients admitted in our hospital from March 2022 to March 2024 were recruited and randomly di-vided into single group(64 cases)and combined group(64 cases).Both groups received routine treatment,and the single group was treated with urapidil while the combined group was given urapidil combined with nimodipine.Clinical efficacy,clinical indicators[cerebral hematoma vol-ume,intracranial pressure(ICP)],neurological function indicators[brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),nerve growth factor(NGF)],hemodynamic pa-rameters[perfusion index(PI),cerebrovascular reserve capacity(CVR),mean bilateral arterial flow velocity],and vascular endothelial function indicators[vascular endothelial growth factor(VEGF),endothelin-1(ET-1),angiopoietin-1(Ang-1)]were compared between the two groups.The incidence of adverse reactions was observed during treatment.Results The total effective rate was significantly higher in the combined group than the single group(89.06%vs 75.00%,P<0.05).After treatment,the ICP,hematoma volume,PI,and levels of NSE,VEGF,ET-1 and Ang-1 in both groups were significantly lower than those before treatment(P<0.05).These indi-cators in the combined group were significantly lower than those in the single group(P<0.05,P<0.01).The CVR,mean bilateral arterial flow velocity,and BDNF and NGF levels were notably increased in both groups after treatment,and the indicators were significantly higher in the com-bined group than the other group(P<0.05,P<0.01).There was no statistical difference in the incidence of adverse reactions between groups(P>0.05).Conclusion Urapidil combined with ni-modipine can shrink the volume of cerebral hematoma,reduce ICP,and improve neurological function,hemodynamics and vascular endothelial function in elderly HICH patients,and the treat-ment does not increase the incidence of adverse reactions.
10.Discussion on curative effect of electronic bronchoscope in treating tracheobronchial tuberculosis at clinical activity stage
Shenglin MO ; Yun HUANG ; Xiaohong HUANG ; Gui TANG ; Yanping SUN ; Jinyu QIN ; Tao CHEN ; Jiaguang HU ; Peng ZHANG ; Jinliang KONG ; Zhongsheng JIANG
China Medical Equipment 2025;22(6):76-80
Objective:To evaluate the clinically curative effect of intervention treatment of electronic bronchoscope in treating tracheobronchial tuberculosis at clinical activity stage.Methods:Sixty patients with tracheobronchial tuberculosis at clinical activity stage(type I,II,III and VI)who admitted to Liuzhou People's Hospital from September 2020 to September 2023 were selected,and they were divided into drug group(anti-tuberculosis drug treatment)and combination group(anti-tuberculosis drug treatment+interventional treatment with electronic bronchoscope)by the random number table method,with 30 cases in each group.The curative effects of the two groups were observed,and the negative conversion rate of sputum bacteria,clinical symptom scores(cough symptom,expectoration symptom)before and after treatment,Modified British Medical Research Council Dyspnea Scale(mMRC)score between two groups were compared,and the differences in indicators of pulmonary function such as forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and maximum voluntary ventilation(MVV)between the two groups also were compared.And then,the incidence of complications was calculated.Results:During the 1,2 and 3 months of follow-up,there were respectively 21 cases,27 cases and 30 cases occurred negative conversion of sputum bacteria in 30 patients of the combination group,and there were respectively 15 cases,18 cases and 23 cases occurred negative conversion of sputum bacteria in 30 patients of the drug group.At the 1st month of follow-up,the negative conversion rate of sputum bacteria in combination group was higher than that in drug group,while there was no statistically significant difference between the two groups(P>0.05).At the 2nd and 3rd month of follow-up,the negative conversion rate of sputum bacteria in the combination group was higher than that in the drug group,and the differences were statistically significant(x2=7.200,7.925,P<0.05).The effective rate of treatment of the combination group was 100%,which was higher than 80%of the drug group,and the difference of that between two groups was significant(x2=6.667,P<0.05).After 2 months of treatment,the mMRC score,cough symptom score and expectoration symptom score of the combination group were all lower than those of the drug group,and the differences were statistically significant(t=3.504,3.950,3.530,P<0.05).The improvement effects of FEV1,FVC and MVV of the combination group were all better than those of the drug group,and the differences were statistically significant(t=6.626,4.966,4.097,P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Anti-tuberculosis drug therapy combined with electronic bronchoscopy intervention has a good therapeutic effect in clinically active tracheobronchial tuberculosis.

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