title: A systematic review of economic evaluations of screening programmes for cardiometabolic diseases.
abstract: The early detection and adequate management of cardiometabolic diseases (CMD) is becoming a priority to prevent future health problems and related healthcare costs.
  
  
  
  This study systematically reviewed the economic evaluations of screening programmes for the early detection of persons at risk for CMD.
  
  
  
  A systematic review was conducted using MEDLINE, Web of Science, NHSEED and the CEA registry to identify relevant articles published between 1 January 2005 and 1 May 2015. Two reviewers independently selected articles, systematically extracted data and critically appraised the study quality using the Extended Consensus on Health Economic Criteria (CHEC) List.
  
  
  
  From the initial 2820 studies identified, 17 were included. Six studies assessed whether screening would be cost-effective, seven aimed to determine the most efficient screening programme and four assessed the cost-effectiveness of existing programmes. There were 11 cost-utility analyses using quality-adjusted life years (QALYs) or disability-adjusted life years. Decision-analytic modelling (e.g. Markov model) was most frequently used (n = 10), followed by simulation models (n = 4), observational (n = 2) and trial-based (n = 1) studies. All studies assessing the cost per QALY gained of screening for cardiovascular diseases and diabetes mellitus (n = 8) were below a threshold of £30 000, while those assessing chronic kidney diseases (n = 2) were above the threshold. Conclusions: In view of the heterogeneity in study objectives, country setting, screening programmes, comparators, methodology and outcomes, it is not possible to make clear recommendations about the economic value of screening programmes for CMD. Developing further screening programmes and conducting thorough economic analysis, including usual care, is needed.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Mickael
authors.initials: M
authors.lastname: Hiligsmann
authors.affiliation: Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands.|Department of Internal Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Wyers
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.|Department of Health Economics, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
authors.forename: Susanne
authors.initials: S
authors.lastname: Mayer
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Evers
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ruwaard
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control; D006801:Humans; D008390:Markov Chains; D008403:Mass Screening / Q000191:economics; D019057:Quality-Adjusted Life Years; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000191:economics / Q000517:prevention & control