A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program--and in particular, the National Institutes of Health's major investment--raising important questions. The volume includes: * Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments. * A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions. * Examination of how this technology's use can be targeted most appropriately. * Attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds.
John R. Hogness and Malin VanAntwerp, Editors; Committee to Evaluate the Artificial Heart Program of the National Heart, Lung, and Blood Institute; Division of Health Care Services
1 Front Matter; 2 Executive Summary; 3 1. The Artificial Heart Program: Current Status and History; 4 2. Total Artificial Hearts: Technological Potential and Research and Development Costs; 5 3. Decisions for Future Research and Development; 6 4. Clinical Effectiveness and Need for Long-Term Circulatory Support; 7 5. Quality of Life and Mechanical Circulatory Support Systems; 8 6. Cost-Effectiveness Analysis; 9 7. The Appropriate Use of Technology; 10 8. Ethical and Societal Issues; 11 9. Roles of Government and Industry in Medical Technology Research, Development and Use; 12 10. Conclusions and Recommendations; 13 Appendix A: History and Methods of This Evaluation; 14 Appendix B: A Chronology of the National Heart, Lung, and Blood Institute Artificial Heart Program and Related Events; 15 Appendix C: Technological Opportunities and Barriers in the Development of Mechanical Circulatory Support Systems; 16 Appendix D: Epidemiology of End-Stage Heart Disease; 17 Appendix E: Assessing the Cost-Effectiveness of the Development and Use of the Total Artificial Heart; 18 Glossary; 19 Index
National Research Council, Division of Behavioral and Social Sciences and Education, Institute of Medicine, and Families Board on Children, Youth, Steve Olson
Institute of Medicine, Board on the Health of Select Populations, and Transgender Health Issues and Research Gaps and Opportunities Committee on Lesbian, Gay, Bisexual
Institute of Medicine, Board on Population Health and Public Health Practice, Division of Health Promotion and Disease Prevention, Division of International Health
Institute of Medicine, Committee to Develop Methods Useful to the Department of Veteran Affairs in Estimating Its Physician Requirements, Joseph Lipscomb
National Research Council, Division of Behavioral and Social Sciences and Education, Institute of Medicine, Commission on Behavioral and Social Sciences and Education, Committee on National Statistics, Division of Health Care Services, Panel on the National Health Care Survey
Institute of Medicine, Division of Health Care Services, Committee on Medicare Coverage Extensions, Lee Zwanziger, Robert L. Lawrence, Marilyn J. Field
Institute of Medicine, Division of Health Care Services, Committee on Medicare Payment Methodology for Clinical Laboratory Services, Lauren LeRoy, Andrea L. Kalfoglou, Dianne Miller Wolman
Institute of Medicine, Division of Health Promotion and Disease Prevention, Division of Health Care Services, Committee on Immunization Finance Policies and Practices