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Cost-effectiveness of mass screening for untreated atrial fibrillation using intermittent ECG recording
Abstract
AIMS: 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. METHODS AND 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.
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“Opportunistic screening for silent AF seems cost-effective in elderly populations (e.g.> 65 years), 131 and similar effects have been reported using single-lead ECG screening in other at-risk populations.132,133”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [132]
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The incidence of atrial fibrillation and the added value of thumb ECG for detecting new cases
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Performance of pulse palpation compared to one‐lead ECG in atrial fibrillation screening
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Cost-Effectiveness of Screening to Identify Patients With Atrial Fibrillation: A Systematic Review
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Metadata
- Authors
- Aronsson, M., Svennberg, E., Rosenqvist, M., Engdahl, J., Al-Khalili, F., Friberg, L., Frykman-Kull, V., & Levin, L.-Å.
- Affiliations
- Linköping University (SE)
- Danderyds sjukhus (SE)
- Hallands sjukhus Halmstad (SE)
- Corresponding author
- Aronsson, Mattias
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-04-12
- Volume
- 17
- Issue
- 7
- Pages
- 1023-1029
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2160206914
- Cited by
- 154
- References
- 48
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 7 · 2023: 9 · 2022: 13 · 2021: 21 · 2020: 15 · 2019: 28 · 2018: 14 · 2017: 16 · 2016: 19 · 2015: 2
- FWCI
- 12.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- atrial fibrillation, mass screening, asymptomatic atrial fibrillation, cost-effectiveness, older adults, stroke prevention, oral anticoagulation, quality-adjusted life years
- MeSH terms
- Aged, Atrial Fibrillation, Cost-Benefit Analysis, Electrocardiography, Female, Humans, Male, Mass Screening, Quality of Life, Sweden, Prevalence, Survival Rate, Health Care Costs, Risk Assessment
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