Long-term benefit and cost-effectiveness analysis of screening for abdominal aortic aneurysms from a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature96967
Source
Br J Surg. 2010 Jun;97(6):826-34
Publication Type
Article
Date
Jun-2010
Author
J S Lindholt
J. Sørensen
R. Søgaard
E W Henneberg
Author Affiliation
Vascular Research Unit, Viborg Hospital, DK-8800 Viborg, Denmark. jes.s.lindholt@viborg.rm.dk
Source
Br J Surg. 2010 Jun;97(6):826-34
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Aged
Aortic Aneurysm, Abdominal - economics - mortality - ultrasonography
Cost-Benefit Analysis
Denmark
Humans
Male
Mass Screening - economics - mortality
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Quality-Adjusted Life Years
Survival Analysis
Treatment Outcome
Abstract
BACKGROUND: The aim was to estimate long-term mortality benefits and cost-effectiveness of screening for abdominal aortic aneurysm (AAA) in men aged 64-73 years. METHODS: All men aged 64-73 years living in Viborg County were randomized to be controls (n = 6306) or invited for abdominal ultrasonography at a regional hospital (n = 6333). Mortality and AAA-related interventions were recorded in national databases. The cost of initial screening was based on actual costs of the programme. Incremental cost-effectiveness ratios (ICERs) were calculated on gains in life years and Quality Adjusted Life Years (QALY). Discounting (3 per cent) was applied to both costs and effects, and all costs were adjusted to euros at 2007 prices. RESULTS: The relative risk reduction of the screening programme in AAA-related mortality was 66 per cent (hazard ratio 0.34, 95 per cent confidence interval (c.i.) 0.20 to 0.57). The corresponding risk reduction in all-cause mortality was 2 per cent (hazard ratio 0.98, 95 per cent c.i. 0.93 to 1.03). The ICER was estimated at euro157 (-3292 to 4401) per life year gained and euro179 (-4083 to 4682) per QALY gained. Screening was found to be cost effective at a probability above 0.97 for a willingness-to-pay threshold of only euro5000. One-way sensitivity analysis demonstrated that this result was robust to various alternative assumptions, as the probability did not drop below 0.90 for any scenario. CONCLUSION: The mortality benefit of screening for AAA in men aged 64-73 years was maintained in the longer term and screening was cost effective.
PubMed ID
20473995 View in PubMed
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