Cost-effectiveness of population-based vascular disease screening and intervention in men from the Viborg Vascular (VIVA) trial
| Autor: | Jes S. Lindholt, Rikke Søgaard |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty National Health Programs Cost effectiveness Cost-Benefit Analysis Denmark Population UNCERTAINTY 030204 cardiovascular system & hematology law.invention Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Mass Screening Humans BENEFIT 030212 general & internal medicine Prospective Studies education Aortic Aneurysm Abdominal/diagnosis Mass screening Aged ABDOMINAL AORTIC-ANEURYSM education.field_of_study Mass Screening/economics business.industry Health Care Costs/statistics & numerical data Health Care Costs Vascular surgery Middle Aged Quality-adjusted life year National Health Programs/economics Peripheral Arterial Disease/diagnosis Relative risk Hypertension Emergency medicine Hypertension/diagnosis Surgery Quality-Adjusted Life Years Risk assessment business Aortic Aneurysm Abdominal Follow-Up Studies |
| Zdroj: | Søgaard, R & Lindholt, J S 2018, ' Cost-effectiveness of population-based vascular disease screening and intervention in men from the Viborg Vascular (VIVA) trial ', British Journal of Surgery, vol. 105, no. 10, pp. 1283-1293 . https://doi.org/10.1002/bjs.10872 |
| DOI: | 10.1002/bjs.10872 |
| Popis: | Background Population-based screening and intervention for abdominal aortic aneurysm, peripheral artery disease and hypertension was recently reported to reduce the relative risk of mortality among Danish men by 7 per cent. The aim of this study was to investigate the cost-effectiveness of vascular screening versus usual care (ad hoc primary care-based risk assessment) from a national health service perspective. Methods A cost-effectiveness evaluation was conducted alongside an RCT involving all men from a region in Denmark (50 156) who were allocated to screening (25 078) or no screening (25 078) and followed for up to 5 years. Mobile nurse teams provided screening locally and, for individuals with positive test results, referrals were made to general practices or hospital-based specialized centres for vascular surgery. Intention-to-treat-based, censoring-adjusted incremental costs (2014 euros), life-years and quality-adjusted life-years (QALYs) were estimated using Lin's average estimator method. Incremental net benefit was estimated using Willan's estimator and sensitivity analyses were conducted. Results The cost of screening was estimated at €148 (95 per cent c.i. 126 to 169), and the effectiveness at 0·022 (95 per cent c.i. 0·006 to 0·038) life-years and 0·069 (0·054 to 0·083) QALYs, generating average costs of €6872 per life-year and €2148 per QALY. At a willingness-to-pay threshold of €40 000 per QALY, the probabilities of cost-effectiveness were 98 and 99 per cent respectively. The probability of cost-effectiveness was 71 per cent when all the sensitivity analyses were combined into one conservative scenario. Conclusion Vascular screening appears to be cost-effective and compares favourably with current screening programmes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|