Cost-effective strategies to screen for left ventricular systolic dysfunction in the community--a concept.
Early detection of heart failure caused by left ventricular systolic dysfunction (LVSD) is important, since early treatment has been shown to retard the progression of heart failure. While traditional echocardiography remains the standard for the detection of LVSD, electrocardiography and serum brain natriuretic peptide have also been shown to predict LVSD. Recently, hand-held echocardiography systems have been shown to have high predictive accuracy for assessment of LVSD. With the availability of the above bedside and relatively less-costly techniques, compared with traditional echocardiography, the major question now is what is the most cost-effective strategy for screening subjects for LVSD. To date, no studies have systematically addressed this issue, but preliminary data are becoming available. This review article discusses the pros and cons of various investigative strategies and likely cost-effectiveness of each strategy to screen for LVSD.
Senior
Roxy
R
Department of Cardiovascular Medicine, Northwick Park and St. Mark's Hospitals, Harrow, Middlesex, HAI 3UJ, UK. roxy.senior@virgin.net
Galasko
Gavin
G
D003153:Community Health Services / Q000191:economics*; D003362:Cost-Benefit Analysis; D004569:Electroencephalography; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000191:economics; D006801:Humans; D008403:Mass Screening / Q000191:economics* / Q000379:methods*; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000191:economics
D020097:Natriuretic Peptide, Brain