Decision-analytical model with lifetime estimation of costs and health outcomes for one-time screening for abdominal aortic aneurysm in 65-year-old men.
BACKGROUND
Abdominal aortic aneurysm (AAA) causes about 2 per cent of all deaths in men over the age of 65 years. A major improvement in operative mortality would have little impact on total mortality, so screening for AAA has been recommended as a solution. The cost-effectiveness of a programme that invited 65-year-old men for ultrasonographic screening was compared with current clinical practice in a decision-analytical model.


METHODS
In a probabilistic Markov model, costs and health outcomes of a screening programme and current clinical practice were simulated over a lifetime perspective. To populate the model with the best available evidence, data from published papers, vascular databases and primary research were used.


RESULTS
The results of the base-case analysis showed that the incremental cost per gained life-year for a screening programme compared with current practice was 7760, and that for a quality-adjusted life-year was 9700. The probability of screening being cost-effective was high.


CONCLUSIONS
A financially and practically feasible screening programme for AAA, in which men are invited for ultrasonography in the year in which they turn 65, appears to yield positive health outcomes at a reasonable cost.
Henriksson
M
M
Centre for Medical Technology Assessment, Linköping University, Linköping, Sweden. martin.henriksson@ihs.liu.se
Lundgren
F
F
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000191:economics / Q000401:mortality; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D009010:Monte Carlo Method; D015995:Prevalence; D011379:Prognosis; D019057:Quality-Adjusted Life Years; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology