What question did this study set out to answer?

This research aims to evaluate the economic benefits of low-intensity monitoring for patients with acute ischemic stroke compared to standard monitoring.

February 2, 2026

Low-Intensity Monitoring for Mild-to-Moderate Acute Ischemic Stroke Is Cost Saving: Economic Evaluation for OPTIMISTmain

Key Points

This research aims to evaluate the economic benefits of low-intensity monitoring for patients with acute ischemic stroke compared to standard monitoring.
Conducted a cost-minimization analysis for multiple countries including Australia, China, and the United States.
Developed a decision tree model comparing two monitoring approaches.
Extracted state transition probabilities and cost data from existing literature.
Performed univariate and probabilistic sensitivity analyses over a 90-day follow-up period.
Low-intensity monitoring showed a 100% probability of cost savings in China and the UK, with significant savings in other countries as well.
In Australia and the US, patients saved approximately $239 and $943, respectively.
Malaysia was the only country where standard care costs were lower than low-intensity monitoring costs, $5643 vs. $5378.
Higher intensive care unit monitoring rates correlated with greater cost savings across countries.

Abstract

BACKGROUND: OPTIMISTmain (Main Optimal Post rtPA-IV Monitoring in Ischemic Stroke Trial) has shown that low-intensity monitoring is feasible and safe compared with standard monitoring in stable patients who receive thrombolysis treatment for acute ischemic stroke of mild-to-moderate neurological impairment. We aimed to estimate the economic benefits of low-intensity care compared with standard care. METHODS: A cost-minimization analysis based on OPTIMISTmain was conducted for Australia, China, Malaysia, the United Kingdom, the United States, and Vietnam. A decision tree model comprising 2 arms was developed from the trial design. State transition probabilities for each country were extracted from the trial, and cost data were sourced from the existing literature. Mean costs over the 90-day duration of follow-up were compared, and univariate and probabilistic sensitivity and scenario analyses were performed. RESULTS: Low-intensity monitoring had the highest probability of cost saving in China (100.00%) and the United Kingdom (100.00%), followed by Australia (99.94%), the United States (95.91%), and Vietnam (86.66%), as patients in this group incurred US dollars savings of 239, 133, 647, 943, and 3 in direct costs compared with patients in the standard group, respectively. In Malaysia, however, the intervention costs slightly exceeded those for standard care (US dollars 5643 versus 5378). Countries with higher proportions of patients having intensive care unit monitoring had greater cost savings. Cost-saving thresholds of monitoring costs were 1.24, 1.30, 1.26, 1.24, 1.01, and 0.91 times the base case value in Australia, China, the United Kingdom, the United States, Vietnam, and Malaysia, respectively. CONCLUSIONS: The low-intensity monitoring protocol was cost saving in countries with high proportions of intensive care resources for postthrombolysis treatment monitoring, such as in the United States. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03734640. URL: https://www.anzctr.org.au/ ; Unique identifier: ACTRN 12619001556134p.

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Cite This Study

Xu et al. (Thu,) studied this question.

synapsesocial.com/papers/6980fc17c1c9540dea80ddab https://doi.org/https://doi.org/10.1161/strokeaha.125.053506

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