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Cost-effectiveness ...
Cost-effectiveness of population screening for atrial fibrillation : the STROKESTOP study
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- Lyth, Johan, 1980- (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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- Svennberg, Emma (författare)
- Karolinska Institutet
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- Bernfort, Lars (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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- Aronsson, Mattias, 1989- (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten,AstraZeneca Nord, Sweden
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- Frykman, Viveka (författare)
- Karolinska Institutet
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- Al-Khalili, Faris (författare)
- Karolinska Inst, Sweden
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- Friberg, Leif (författare)
- Karolinska Inst, Sweden
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- Rosenqvist, Mårten (författare)
- Karolinska Inst, Sweden
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- Engdahl, Johan (författare)
- Karolinska Institutet
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- Levin, Lars-Åke (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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(creator_code:org_t)
- 2022-11-09
- 2023
- Engelska.
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 3:3, s. 196-204
- Relaterad länk:
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https://liu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
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- Aims Previous studies on the cost-effectiveness of screening for atrial fibrillation (AF) are based on assumptions of long-term clinical effects. The STROKESTOP study, which randomised 27 975 persons aged 75/76 years into a screening invitation group and a control group, has a median follow-up time of 6.9 years. The aim of this study was to estimate the cost-effectiveness of population-based screening for AF using clinical outcomes. Methods and results The analysis is based on a Markov cohort model. The prevalence of AF, the use of oral anticoagulation, clinical event data, and all-cause mortality were taken from the STROKESTOP study. The cost for clinical events, age-specific utilities, utility decrement due to stroke, and stroke death was taken from the literature. Uncertainty in the model was considered in a probabilistic sensitivity analysis. Per 1000 individuals invited to the screening, there were 77 gained life years and 65 gained quality-adjusted life years. The incremental cost was euro1.77 million lower in the screening invitation group. Gained quality-adjusted life years to a lower cost means that the screening strategy was dominant. The result from 10 000 Monte Carlo simulations showed that the AF screening strategy was cost-effective in 99.2% and cost-saving in 92.7% of the simulations. In the base-case scenario, screening of 1000 individuals resulted in 10.6 [95% confidence interval (CI): -22.5 to 1.4] fewer strokes (8.4 ischaemic and 2.2 haemorrhagic strokes), 1.0 (95% CI: -1.9 to 4.1) more cases of systemic embolism, and 2.9 (95% CI: -18.2 to 13.1) fewer bleedings associated with hospitalization. Conclusion Based on the STROKESTOP study, this analysis shows that a broad AF screening strategy in an elderly population is cost-effective. Efforts should be made to increase screening participation.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- Atrial fibrillation; Screening; Stroke prevention; Cost-effectiveness; Markov modelling
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- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Lyth, Johan, 198 ...
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Svennberg, Emma
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Bernfort, Lars
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Aronsson, Mattia ...
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Frykman, Viveka
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Al-Khalili, Fari ...
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visa fler...
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Friberg, Leif
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Rosenqvist, Mårt ...
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Engdahl, Johan
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Levin, Lars-Åke
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European Heart J ...
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Linköpings universitet
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Karolinska Institutet