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Using advanced statistical modeling, we found that home AED use was associated with improved 
outcomes among patients presenting with an initial shockable rhythm, representing approximately 16% 
of all patients. Survival to hospital discharge increased from 22% to 28%, representing a 26% relative 
increase, and this finding was both robust and statistically significant. In contrast, home AED use did not 
improve outcomes among patients with a non-shockable rhythm, for whom survival was approximately 
4.5% regardless of AED use. This finding is consistent with the mechanism of an AED, which delivers a 
shock only when a shockable rhythm is detected. 
In our cost-effectiveness analysis, 
we considered both the clinical 
benefits of home AED use and 
the associated costs, primarily 
the cost of purchasing the device. 
Because cardiac arrest in any 
specific home is rare and difficult 
to predict, AEDs would need to 
be placed in a very large number 
of homes to ensure availability 
when needed. This reality was 
reflected in our results. To 
gain one quality-adjusted life 
year (QALY)—defined as one 
additional year of life in perfect 
health—the estimated cost 
was approximately $4.5 million 
USD. This value is substantially 
higher than commonly accepted 
cost-effectiveness thresholds, 
indicating that indiscriminate 
purchase of AEDs for all private 
homes is not currently cost-
effective.
However, this conclusion 
may change under certain 
circumstances. If future studies 
can identify individuals or 
households at particularly high 
risk of cardiac arrest, targeted 
AED placement in those homes 
could potentially become cost-
effective. Alternatively, the cost of 
AED devices may decrease over time, which could also improve cost-effectiveness in the home setting. 
Our study highlights the unique value of the CARES registry for addressing important clinical and public 
health questions related to cardiac arrest. In summary, AED use in private homes improves survival 
among patients presenting with a shockable rhythm. Because cardiac arrests at home are common at 
the population level, expanding access to AEDs in residential settings has the potential to save thousands 
of lives each year. However, given the low event rate within individual homes and the current cost of 
devices, our analysis suggests that routine purchase of AEDs for all private residences cannot currently 
be considered cost-effective.
1. Andersen, L. W., Holmberg, M. J., Krijkamp, E., Stankovic, N., Meilandt, C., Vallentin, M. F., Høybye, M., Folke, F., 
Kunst, N., Dijk, S., Granfeldt, A., & Caulley, L. (2026). Effectiveness and cost-effectiveness of automated external 
defibrillators in private homes: A report from the Cardiac Arrest Registry to Enhance Survival. JAMA Internal Medicine, 
186(1), 37–43. https://doi.org/10.1001/jamainternmed.2025.6123 
Figure 1. Relationship between cardiac arrest incidence and the 
incremental cost-effectiveness ratio.
The x-axis represents the yearly incidence of cardiac arrest for each 
household member. The base case incidence was 0.06% (vertical dotted 
line). At a yearly incidence above 0.6%, having an AED in a private home 
would be considered cost-effective at a willingness-to-pay threshold of 
$200,000 (horizontal dotted line).
From Andersen LW, Holmberg MJ, Krijkamp E, et al. Effectiveness and Cost-Effectiveness of 
Automated External Defibrillators in Private Homes: A Report From the Cardiac Arrest Registry 
to Enhance Survival. JAMA Internal Medicine. Published online October 25, 2025. doi:10.1001/
jamainternmed.2025.6123. Used with Permission. Copyright © 2025 American Medical 
Association. All rights reserved.
Figure 1

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