R J Darwood1, M J Brooks. 1. Department of Vascular Surgery, Bristol Royal Infirmary, United Hospitals Bristol NHS Trust, Upper Maudlin Street, Bristol BS2 8HW, UK. rosie_darwood@btinternet.com
Abstract
OBJECTIVES: The NHS Abdominal Aortic Aneurysm Screening Programme (NAAASP), based on the Multicentre Aneurysm Screening Study (MASS) trial (2002), is being introduced across the UK. Recent studies have demonstrated a decline in prevalence of abdominal aortic aneurysm (AAA). The aim of this study was to examine the effect of this on screening workload. METHODS: A model was developed to predict screening and surgical workload for a screening centre (Bristol - population 1,123,203). Workload was compared using data from MASS with data from the "Early Implementers" (EI) of NAAASP. RESULTS: Modelling for 2011/2012 using EI data predicted significantly fewer men diagnosed with an AAA compared to MASS data [84 (EI) versus 198 (MASS) p < 0.0001] and fewer referrals to a vascular surgeon for AAA repair [10 (EI) versus 30 (MASS) p = 0.0002). This difference became more marked with time (2015/16: 90 (EI) versus 212 (MASS) men diagnosed with an AAA (p < 0.0001) and 29 (EI) versus 71 (MASS) referred to a vascular surgeon (p < 0.0001)). From 2015/16 there was also a significant reduction in the predicted number of ultrasound scans. CONCLUSIONS: Modelling screening activity based on contemporary epidemiological data demonstrates a significant reduction in workload compared to MASS data. This has implications for workforce planning, the introduction of new screening centres and the future of NAAASP.
OBJECTIVES: The NHS Abdominal Aortic Aneurysm Screening Programme (NAAASP), based on the Multicentre Aneurysm Screening Study (MASS) trial (2002), is being introduced across the UK. Recent studies have demonstrated a decline in prevalence of abdominal aortic aneurysm (AAA). The aim of this study was to examine the effect of this on screening workload. METHODS: A model was developed to predict screening and surgical workload for a screening centre (Bristol - population 1,123,203). Workload was compared using data from MASS with data from the "Early Implementers" (EI) of NAAASP. RESULTS: Modelling for 2011/2012 using EI data predicted significantly fewer men diagnosed with an AAA compared to MASS data [84 (EI) versus 198 (MASS) p < 0.0001] and fewer referrals to a vascular surgeon for AAA repair [10 (EI) versus 30 (MASS) p = 0.0002). This difference became more marked with time (2015/16: 90 (EI) versus 212 (MASS) men diagnosed with an AAA (p < 0.0001) and 29 (EI) versus 71 (MASS) referred to a vascular surgeon (p < 0.0001)). From 2015/16 there was also a significant reduction in the predicted number of ultrasound scans. CONCLUSIONS: Modelling screening activity based on contemporary epidemiological data demonstrates a significant reduction in workload compared to MASS data. This has implications for workforce planning, the introduction of new screening centres and the future of NAAASP.