title: Cost-effectiveness of mass screening for untreated atrial fibrillation using intermittent ECG recording.
abstract: OBJECTIVE
  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.
  
  
  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.
authors: Department of Medical and Health Sciences, Centre for Medical Technology Assessment, Linkoping University, SE-581 83 Linkoping, Sweden mattias.aronsson@liu.se.
authors: Mattias
authors: M
authors: Aronsson
authors: Karolinska Institutet, Department of Clinical Science, Cardiology Unit, Danderyd University Hospital, Stockholm, Sweden.
authors: Emma
authors: E
authors: Svennberg
authors: Karolinska Institutet, Department of Clinical Science, Cardiology Unit, Danderyd University Hospital, Stockholm, Sweden.
authors: Mårten
authors: M
authors: Rosenqvist
authors: Department of Medicine, Halland Hospital, Halmstad, Sweden.
authors: Johan
authors: J
authors: Engdahl
authors: Karolinska Institutet, Department of Clinical Science, Cardiology Unit, Danderyd University Hospital, Stockholm, Sweden Stockholm Heart Centre, Stockholm, Sweden.
authors: Faris
authors: F
authors: Al-Khalili
authors: Karolinska Institutet, Department of Clinical Science, Cardiology Unit, Danderyd University Hospital, Stockholm, Sweden.
authors: Leif
authors: L
authors: Friberg
authors: Karolinska Institutet, Department of Clinical Science, Cardiology Unit, Danderyd University Hospital, Stockholm, Sweden.
authors: Viveka
authors: V
authors: Frykman-Kull
authors: Department of Medical and Health Sciences, Centre for Medical Technology Assessment, Linkoping University, SE-581 83 Linkoping, Sweden.
authors: Lars-Åke
authors: LÅ
authors: Levin
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000401:mortality* / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D004562:Electrocardiography / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000706:statistics & numerical data; D015995:Prevalence; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology
keywords: Atrial fibrillation; Cost-effectiveness; Hand-held ECG; Quality-adjusted life year (QALY); Screening