التفاصيل البيبلوغرافية
| العنوان: |
Should we screen women for abdominal aortic aneurysm? Analysis of clinical benefit, harms and cost-effectivenes |
| المؤلفون: |
Sweeting, M, Masconi, KL, Jones, E, Ulug, P, Glover, MJ, Michaels, JA, Bown, MJ, Powell, JT, Thompson, SG |
| المساهمون: |
National Institute for Health Research |
| بيانات النشر: |
Elsevier |
| سنة النشر: |
2018 |
| المجموعة: |
Imperial College London: Spiral |
| مصطلحات موضوعية: |
11 Medical And Health Sciences, General & Internal Medicine |
| الوصف: |
Backgroud: One-third of UK deaths from ruptured abdominal aortic aneurysm (AAA) are in women. In men, national screening programmes reduce deaths from AAA and are cost-effective. The benefits, harms and cost-effectiveness in offering a similar programme to women have not been formally assessed. Methods: A discrete event simulation model was set up for AAA screening, surveillance and intervention. Relevant women-specific parameters were obtained from sources including systematic literature reviews, national registry/administrative databases, major AAA surgery trials, and UK National Health Service reference costs. Findings: AAA screening for women, as currently offered to UK men (at age 65, AAA diagnosis at an aortic diameter of ≥3.0cm and elective repair considered at ≥5.5cm) gave, over a 30-yeartime horizon, an estimated incremental cost effectiveness ratio (ICER) of £30,000 (95% CI 12,000 to 87,000) per quality adjusted life-year (QALY) gained, with 3,900 invitations to screening required to prevent one AAA-death and an over-diagnosis rate of 33%. A modified option for women (screening at age 70, diagnosis at 2.5cm and repair at 5.0cm) was estimated to be more cost-effective, with an ICER of £23,000 (9,500 to 71,000) per QALY and 1,800 invitations to screening required to prevent one AAA-death, but an over-diagnosis rate of 55%. There was considerable uncertainty in the ICER, largely driven by uncertainty about AAA prevalence,the distribution of aortic sizes for women at different ages and the impact of screening on quality-of-life. Interpretation: By UK standards an AAA screening programme for women, mimicking that in men, is unlikely to be cost-effective. Further research on the aortic diameter distribution in women and potential quality of life decrements associated with screening are needed to assess the full benefits and harms of modified options. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
unknown |
| تدمد: |
0140-6736 |
| العلاقة: |
Lancet; http://hdl.handle.net/10044/1/60271Test; RG77721 |
| الإتاحة: |
http://hdl.handle.net/10044/1/60271Test |
| رقم الانضمام: |
edsbas.AD12C1E9 |
| قاعدة البيانات: |
BASE |
