Mattias Aronsson1, Emma Svennberg2, Mårten Rosenqvist2, Johan Engdahl3, Faris Al-Khalili4, Leif Friberg2, Viveka Frykman-Kull2, Lars-Åke Levin5. 1. Department of Medical and Health Sciences, Centre for Medical Technology Assessment, Linkoping University, SE-581 83 Linkoping, Sweden mattias.aronsson@liu.se. 2. Karolinska Institutet, Department of Clinical Science, Cardiology Unit, Danderyd University Hospital, Stockholm, Sweden. 3. Department of Medicine, Halland Hospital, Halmstad, Sweden. 4. Karolinska Institutet, Department of Clinical Science, Cardiology Unit, Danderyd University Hospital, Stockholm, Sweden Stockholm Heart Centre, Stockholm, Sweden. 5. Department of Medical and Health Sciences, Centre for Medical Technology Assessment, Linkoping University, SE-581 83 Linkoping, Sweden.
Abstract
AIMS: The aim of this study was to estimate the cost-effectiveness of 2 weeks of intermittent screening for asymptomatic atrial fibrillation (AF) in 75/76-year-old individuals. METHODS AND RESULTS: The cost-effectiveness analysis of screening in 75-year-old individuals was based on a lifelong decision analytic Markov model. In this model, 1000 hypothetical individuals, who matched the population of the STROKESTOP study, were simulated. The population was analysed for different parameters such as prevalence, AF status, treatment with oral anticoagulation, stroke risk, utility, and costs. In the base-case scenario, screening of 1000 individuals resulted in 263 fewer patient-years with undetected AF. This implies eight fewer strokes, 11 more life-years, and 12 more quality-adjusted life years (QALYs) per 1000 screened individuals. The screening implies an incremental cost of €50 012, resulting in a cost of €4313 per gained QALY and €6583 per avoided stroke. CONCLUSIONS: With the use of a decision analytic simulation model, it has been shown that screening for asymptomatic AF in 75/76-year-old individuals is cost-effective. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The aim of this study was to estimate the cost-effectiveness of 2 weeks of intermittent screening for asymptomatic atrial fibrillation (AF) in 75/76-year-old individuals. METHODS AND RESULTS: The cost-effectiveness analysis of screening in 75-year-old individuals was based on a lifelong decision analytic Markov model. In this model, 1000 hypothetical individuals, who matched the population of the STROKESTOP study, were simulated. The population was analysed for different parameters such as prevalence, AF status, treatment with oral anticoagulation, stroke risk, utility, and costs. In the base-case scenario, screening of 1000 individuals resulted in 263 fewer patient-years with undetected AF. This implies eight fewer strokes, 11 more life-years, and 12 more quality-adjusted life years (QALYs) per 1000 screened individuals. The screening implies an incremental cost of €50 012, resulting in a cost of €4313 per gained QALY and €6583 per avoided stroke. CONCLUSIONS: With the use of a decision analytic simulation model, it has been shown that screening for asymptomatic AF in 75/76-year-old individuals is cost-effective. Published on behalf of the European Society of Cardiology. All rights reserved.
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