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Cost-effectiveness of screening for atrial fibrillation in primary care with a handheld, single-lead electrocardiogram device in the Netherlands
- Source :
- Europace, 20(1), 12-18. Oxford University Press
- Publication Year :
- 2016
- Publisher :
- Oxford University Press (OUP), 2016.
-
Abstract
- Aims Atrial fibrillation (AF) is the most common arrhythmia and prevalence increases with age. Patients with AF have a high risk of stroke, and screening for AF is recommended in all people aged 65 years or older to identify patients eligible for stroke prevention. A handheld, single-lead electrocardiogram (ECG) device can be used for systematic screening in the population at risk. The objective of this study is to estimate the cost-effectiveness of screening for AF in primary care with the MyDiagnostick (R) during seasonal influenza vaccination in the Netherlands.Methods and results Lifetime costs and effects of a single screening session for AF detection were assessed from a societal perspective with a decision analytic model consisting of a straightforward decision tree and a joining Markov model. The decision model simulated all patients aged 65 years and over attending the seasonal influenza vaccination in the Netherlands. Event probabilities were derived from clinical trials. Sensitivity analyses were performed to assess the impact of important model assumptions as well as determining the relative effect of individual parameters. Screening for AF with the MyDiagnostick (R) in all patients older than 65 years that attend seasonal influenza vaccination in the Netherlands would decrease the overall costs by (sic)764 and increase the quality-adjusted life-years (QALYs) by 0.27 years per patient. Early detection of AF would prevent strokes and leads to beneficial health effects with subsequent cost savings. This screening method would have an estimated probability of 99.8% for being cost-effective at a conservative willingness-to-pay of (sic)20 000/QALY.Conclusion Screening for AF in primary care with a handheld, single-lead ECG during seasonal influenza vaccination is very likely to be cost saving for identifying new cases of AF in the Dutch population aged 65 years and over. Active screening for AF with a single-lead, handheld ECG device during seasonal influenza vaccination could be implemented in primary care.
- Subjects :
- Male
Health economic modelling
Cost effectiveness
Cost-Benefit Analysis
AGED 65
030204 cardiovascular system & hematology
GUIDELINES
law.invention
Electrocardiography
0302 clinical medicine
Randomized controlled trial
law
Stroke prevention
Mass Screening
030212 general & internal medicine
Stroke
Netherlands
CARDIOLOGY
education.field_of_study
Vaccination
Atrial fibrillation
Health Care Costs
RANDOMIZED CONTROLLED-TRIAL
Primary care
Markov Chains
Models, Economic
ISCHEMIC-STROKE
Influenza Vaccines
Point-of-Care Testing
Screening
Female
Quality-Adjusted Life Years
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Clinical Decision-Making
Population
ESC
Decision Support Techniques
03 medical and health sciences
Cost Savings
Predictive Value of Tests
Physiology (medical)
MANAGEMENT
medicine
Humans
Computer Simulation
Intensive care medicine
education
METAANALYSIS
Aged
Primary Health Care
business.industry
Decision Trees
Reproducibility of Results
medicine.disease
Clinical trial
ROUTINE PRACTICE
Emergency medicine
Single-lead ECG
Cost-effectiveness
business
Subjects
Details
- ISSN :
- 15322092 and 10995129
- Database :
- OpenAIRE
- Journal :
- Europace
- Accession number :
- edsair.doi.dedup.....8b563d7a6bb7be7b15df8059ca3d1fdf
- Full Text :
- https://doi.org/10.1093/europace/euw285