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Background This study evaluated public preferences for the treatment processes for abdominal aortic aneurysm repair in order to allow them to be incorporated into a cost‐effectiveness analysis. Methods This was a telephone survey using a trade‐off method in UK resident adults (aged at least 18 years) with no previous diagnosis of a vascular condition. Results Some 167 of 209 participants (79·9 per cent) stated that they would prefer endovascular aneurysm repair (EVAR), 40 (19·1 per cent) preferred open surgery and two (1·0 per cent) stated no preference. Participants preferred EVAR because of the less invasive nature of the intervention and quicker recovery. Participants preferring open surgery cited reasons such as having a single follow‐up appointment, and a procedure that felt more permanent. When participants were asked to make a sacrifice in order to have their preferred treatment, 122 (58·4 per cent) favoured EVAR, 18 (8·6 per cent) favoured open surgery and 69 (33·0 per cent) had no preference. Those preferring EVAR were willing to give up a mean of 0·135 expected quality‐adjusted life‐years (QALYs) to have EVAR, compared with a willingness to give up 0·033 expected QALYs among those preferring open repair. Conclusion These results indicate a clear preference for EVAR over open surgery for aortic aneurysm.

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The authors measured the percentage of children aged 6 through 17 whose blood pressure (BP) was not measured during recent nonemergency clinical examination and assessed the relative importance of health, ability-to-pay, language, and race-ethnic factors in determining whether BP was measured. Using a pooled dataset from the Medical Expenditure Panel Survey (MEPS) for 2006 and 2007, the authors calculated the percentage of children whose BP was not measured using a sample of children aged 6 through 17 and constructed a logistic regression model to estimate the relative importance of health, economic, and social factors in the examiner's decision to measure BP. A total of 28.9% of children did not have their BP measured. Within this unmeasured group, 31% had a family history of hypertension, 9% had a family history of diabetes, and 5% had a body mass index 32 kg ⁄ m 2 . The logistic regression model of examiners' decisions indicates that social and economic factors strongly compete with health factors in determining which children not to measure. While examiners place many children at risk for hypertension in the measured pool, they also place many at-risk children in the unmeasured pool for economic and social reasons. J Clin Hypertens (Greenwich). 2011;13:767-773. Ó2011 Wiley Periodicals, Inc.The prevalence of hypertension among children and adolescents in the United States is estimated to be between 3% and 5%.1,2 Factors related to higher blood pressure (BP) among children and adolescents are obesity ⁄ overweight, 3-12 low birth weight, 13-15 family history of hypertension, 16,17 and poor sleep quality.18 Non-Hispanic blacks and Mexican American children are at higher risk for prehypertension and hypertension compared with non-Hispanic white children. 12,19,20 In addition, lower socioeconomic status predicts hypertension. 21 Current guidelines recommend that all children 3 years and older have their BP measured at each health care visit. 13 It is known that this recommendation is often not followed by providers. 22 Despite this prevalence, due to the complexity of the definition for hypertension among children, even when BP is measured, Falkner and colleagues 2 argue that hypertension in children is underdiagnosed because it is easily missed, even by health professionals. Underdiagnosed hypertension can damage organs and cause early cardiovascular-related disease in early adulthood. 2,14However, underdiagnosis can also occur simply by failing to measure BP. Factors known to discourage routine testing include patient characteristics that predict normal BP such as younger age, female sex, low body mass index (BMI), and an absence of cardiovascular disease in the family. 22 We find that factors associated with inability-to-pay, English-language handicaps, and minority status also discourage BP measurement. Here we show that in the Medical Expenditure Panel Survey (MEPS), a nationally representative sample of nonemergency clinic and hospital visits in 2006-2007, examiners did not measure the BP of 34% of children ...