[Screening for abdominal aortic aneurysm; effectivity and cost-effectiveness].
OBJECTIVE
To review the current literature concerning the effectivity and cost-effectiveness of screening for abdominal aortic aneurysm (AAA).


METHODS
Systematic review.


METHODS
A review of literature of evaluations of effectivity via meta-analyses and economic evaluations.


RESULTS
The short-term meta-analyses showed that screening for AAA leads to a significant reduction of AAA-related mortality. The average absolute risk reduction (ARR) was 0.12%. The long-term meta-analysis also showed a significant reduction of overall mortality. The ARR was in this case almost 1%. The five economic evaluations all resulted in cost-effectiveness ratios below euro 20,000 per quality-adjusted life year (QALY), a used threshold level in the Netherlands.


CONCLUSIONS
Based on the available literature, screening for AAA has appeared to be both effective and cost-effective. However, the economic evaluations did not always take into account the peri- and post-operative mortality and morbidity. Economic evaluations are only useful if all possible outcomes are included in the model. Therefore a good model analysis should be made for the Dutch situation, after which a decision may be taken on a possible pilot study and the optimal design thereof.
Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven, The Netherlands. paul.van.gils@rivm.nl
Paul F
PF
van Gils
G Ardine
GA
de Wit
Albertine J
AJ
Schuit
Matthijs
M
van den Berg
D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000191:economics / Q000401:mortality*; D001019:Aortic Rupture / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D006801:Humans; D008017:Life Expectancy; D008403:Mass Screening / Q000191:economics* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors