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Cost-Effectiveness of Project ADAM

A Project to Prevent Sudden Cardiac Death in High School Students

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Abstract

Public access defibrillation (PAD) in the adult population is thought to be both efficacious and cost-effective. Similar programs aimed at children and adolescents have not been evaluated for their cost-effectiveness. This study evaluates the potential cost-effectiveness of implementing Project ADAM, a program targeting children and adolescents in high schools in the Milwaukee Public School System. Project ADAM provides education about cardiopulmonary resuscitation (CPR) and the warning signs of sudden cardiac death (SCD) and training in the use and placement of automated external defibrillators (AEDs) in high schools. We developed decision analysis models to evaluate the cost-effectiveness of the decision to implement Project ADAM in public high schools in Milwaukee. We examined clinical model and public policy applications. Data on costs included estimates of hospital-based charges derived from a pediatric medical center where a series of patients were treated for SCD, educational programming, and the direct costs of one AED and training for 15 personnel per school. We performed sensitivity analyses to assess the variation in outputs with respect to changes to input data. The main outcome measures were Life years saved and incremental cost-effectiveness ratios. At an arbitrary societal willingness to pay $100,000 per life year saved, the policy to implement Project ADAM in schools is a cost-effective strategy at a threshold of approximately 5 patients over 5 years for the clinical model and approximately 8 patients over 5 years for the public policy model. Implementation of Project ADAM in high schools in the United States is potentially associated with an incremental cost-effectiveness ratio that is favorable.

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Acknowledgments

We thank the following for their assistance in the development of the models used in this cost-effectiveness analysis: Karen Bauer (Children’s Hospital of Wisconsin), Edward McMilin (Milwaukee Public School System), Cecelia Needham (Medical College of Wisconsin), Andrew Pelech (Medical College of Wisconsin), and Susan Wendt (Children’s Health System). In addition, we acknowledge the following individuals for their assistance and support in the development and implementation of Project ADAM: David Ellis, Robert Kliegman (Medical College of Wisconsin), Joe and Patty Lemel, David Petasnick (Children’s Hospital of Wisconsin), and Becki Jo Hirschy (Children’s Hospital of Wisconsin).

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Authors and Affiliations

  1. Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53226, USA

    S. Berger, B. N. Whitstone, A. Dhala, L. M. Utech & R. C. Sachdeva

  2. Quality and Outcomes Management, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue, MS 713, Milwaukee, WI, 53226, USA

    S. J. Frisbee & R. C. Sachdeva

  3. Department of Finance, Children’s Hospital of Wisconsin, 9000 W. Wisconsin Avenue MS 713, Milwaukee, WI, 53226, USA

    J. T. Miner

  4. Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA

    R. G. Pirrallo

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  1. S. Berger
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  2. B. N. Whitstone
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  3. S. J. Frisbee
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  4. J. T. Miner
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  5. A. Dhala
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  6. R. G. Pirrallo
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  7. L. M. Utech
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  8. R. C. Sachdeva
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Correspondence to S. Berger.

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Berger, S., Whitstone, B.N., Frisbee, S.J. et al. Cost-Effectiveness of Project ADAM. Pediatr Cardiol 25, 660–667 (2004). https://doi.org/10.1007/s00246-003-0668-z

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  • DOI: https://doi.org/10.1007/s00246-003-0668-z

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