Revisiting the cost-effectiveness of screening 65-year-old men for abdominal aortic aneurysm based on data from an implemented screening program

Hager, Jakob; Henriksson, Martin; Carlsson, Per; Länne, Toste; Lundgren, Fredrik

doi:10.23736/s0392-9590.16.03777-9

Cited by 8 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent report, the Dutch Health Council did not advise routine population screening for AAA in the Netherlands after an extensive evaluation of existing trials and screening programs implemented worldwide (12). Although reports evaluating the existing large screening programs in England and Sweden do show clear benefits in terms of AAA-related mortality and low costs per quality-adjusted lifeyear (QALY) gained, the true prevalence of AAA in the screened groups turned out to be lower than expected (13)(14)(15)(16). Multiple recent reports show a decreasing prevalence of AAA (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

High prevalence of abdominal aortic aneurysm in older men with cerebrovascular disease: Evaluation of a local screening program

et al. 2023

View full text Add to dashboard Cite

IntroductionPatients with cerebrovascular disease may suffer from other vascular morbidities, such as abdominal aortic aneurysm (AAA). Previously, a high prevalence of AAA has been demonstrated in men 60 years of age and older who have experienced TIA or stroke. This report evaluates the results of a decade's operation of a local screening program for AAA in this selected neurologic population.MethodsMen aged ≥60 years and admitted to the neurology ward of a community-based hospital in the Netherlands from 2006 to 2017 with a diagnosis of TIA or stroke were selected for screening. The diameter of the abdominal aorta was assessed by abdominal ultrasonography. Patients with detected AAA were referred for evaluation by a vascular surgeon.ResultsAAA was detected in 72 of 1,035 screened patients (6.9%). AAAs with a diameter of 3.0–3.9 cm accounted for 61.1% of the total aneurysms found; AAAs with a diameter of 4.0–5.4 cm accounted for 20.8% of the total; and large aneurysms with a diameter of ≥5.5 cm accounted for 18.1% of all aneurysms discovered. A total of 18 patients (1.7%) underwent elective aneurysm repair.DiscussionThe detection rate of AAA in older men with cerebrovascular disease was roughly 5-fold the detection rate in known European screening programs in older men from the general population. The proportion of large AAAs (≥5.5 cm) was also substantially higher. These findings reveal a previously unknown co-morbidity in patients with cerebrovascular disease and may be helpful for cardiovascular management of this large group of neurologic patients. Current and future AAA screening programs may also benefit from this knowledge.

show abstract

Section: Introductionmentioning

confidence: 99%

High prevalence of abdominal aortic aneurysm in older men with cerebrovascular disease: Evaluation of a local screening program

et al. 2023

View full text Add to dashboard Cite

show abstract

Health gains, costs and cost-effectiveness of a population-based screening programme for abdominal aortic aneurysms

Nair

Kvizhinadze

Jones

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

Background Abdominal aortic aneurysm (AAA) rupture carries a high fatality rate. AAAs can be detected before rupture by abdominal ultrasound imaging, allowing elective repair. Population‐based screening for AAA in older men reduces AAA‐related mortality by about 40 per cent. The UK began an AAA screening programme offering one‐off scans to men aged 65 years in 2009. Sweden has a similar programme. Currently, there is no AAA screening programme in New Zealand. This cost–utility analysis aimed to assess the cost‐effectiveness of a UK‐style screening programme in the New Zealand setting. Methods The analysis compared a formal AAA screening programme (one‐off abdominal ultrasound imaging for about 20 000 men aged 65 years in 2011) with no systematic screening. A Markov macrosimulation model was adapted to estimate the health gains (in quality‐adjusted life‐years, QALYs), health system costs and cost‐effectiveness in New Zealand. A health system perspective and lifetime horizon was adopted. Results With New Zealand‐specific inputs, the adapted model produced an estimate of about NZ $15 300 (€7746) per QALY gained, with a 95 per cent uncertainty interval (UI) of NZ $8700 to 31 000 (€4405 to 15 694) per QALY gained. Health gains were estimated at 117 (95 per cent UI 53 to 212) QALYs. Health system costs were NZ $1·68 million (€850 535), with a 95 per cent UI of NZ $820 200 to 3·24 million (€415 243 to €1·65 million). Conclusion Using New Zealand's gross domestic product per capita (about NZ $45 000 or €22 100) as a cost‐effectiveness threshold, a UK‐style AAA screening programme would be cost‐effective in New Zealand.

show abstract

Health Economic Research Assessing the Value of Early Detection of Cardiovascular Disease: A Systematic Review

et al. 2023

View full text Add to dashboard Cite

Introduction Cardiovascular disease (CVD) is the most prominent cause of death worldwide and has a major impact on healthcare budgets. While early detection strategies may reduce the overall CVD burden through earlier treatment, it is unclear which strategies are (most) efficient. Aim This systematic review reports on the cost effectiveness of recent early detection strategies for CVD in adult populations at risk. Methods PubMed and Scopus were searched to identify scientific articles published between January 2016 and May 2022. The first reviewer screened all articles, a second reviewer independently assessed a random 10% sample of the articles for validation. Discrepancies were solved through discussion, involving a third reviewer if necessary. All costs were converted to 2021 euros. Reporting quality of all studies was assessed using the CHEERS 2022 checklist. Results In total, 49 out of 5552 articles were included for data extraction and assessment of reporting quality, reporting on 48 unique early detection strategies. Early detection of atrial fibrillation in asymptomatic patients was most frequently studied ( n = 15) followed by abdominal aortic aneurysm ( n = 8), hypertension ( n = 7) and predicted 10-year CVD risk ( n = 5). Overall, 43 strategies (87.8%) were reported as cost effective and 11 (22.5%) CVD-related strategies reported cost reductions. Reporting quality ranged between 25 and 86%. Conclusions Current evidence suggests that early CVD detection strategies are predominantly cost effective and may reduce CVD-related costs compared with no early detection. However, the lack of standardisation complicates the comparison of cost-effectiveness outcomes between studies. Real-world cost effectiveness of early CVD detection strategies will depend on the target country and local context. Registration of Systematic Review CRD42022321585 in International Prospective Registry of Ongoing Systematic Reviews (PROSPERO) submitted at 10 May 2022 Supplementary Information The online version contains supplementary material available at 10.1007/s40273-023-01287-2.

show abstract

Revisiting the cost-effectiveness of screening 65-year-old men for abdominal aortic aneurysm based on data from an implemented screening program

Cited by 8 publications

References 0 publications

High prevalence of abdominal aortic aneurysm in older men with cerebrovascular disease: Evaluation of a local screening program

High prevalence of abdominal aortic aneurysm in older men with cerebrovascular disease: Evaluation of a local screening program

Health gains, costs and cost-effectiveness of a population-based screening programme for abdominal aortic aneurysms

Health Economic Research Assessing the Value of Early Detection of Cardiovascular Disease: A Systematic Review

Contact Info

Product

Resources

About