Clement, Fiona M.Hofmeister, Mark Ronald2018-07-112018-07-112018-07-06Hofmeister, M. R. (2018). An Economic Evaluation of the Syncope: Pacing or Recording in the Later Years (SPRITELY) Trial (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/32351http://hdl.handle.net/1880/107129The Syncope: Pacing or Recording In ThE Later Years (SPRITELY) trial tests the hypothesis that pacemaker insertion in patients with syncope, bifascicular block, and age greater than 50 years prevents syncope recurrences and major clinical events more effectively than therapy guided by monitoring with an implantable loop recorder. Equipoise or uncertainty reflected in guidelines and recommendations for both strategies may contribute to variation in management and inefficient resource use. Clinical analysis of the SPRITELY trial is complemented with an economic evaluation. The goal of this thesis was to establish the relative cost-effectiveness of the implantable loop recorder and the pacemaker in patients with bifascicular block, unexplained syncope, and age greater than 50 years. An economic evaluation of the SPRITELY trial was conducted to match the prespecified time horizon of two years for the clinical analysis (Chapter 3), and a decision analytic model was built to extend the time horizon to three years to match clinical practice (Chapter 4). In Chapter 5, the effect of taking three different national perspectives for the SPRITELY trial evaluation was explored. This thesis ends with a discussion and conclusions in Chapter 6.engUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.Health EconomicsBifascicular blockSyncopePacemakerImplantable loop recorderHealth Sciencesmaster thesis10.11575/PRISM/32351