Implications of attendance patterns in Northern Ireland for abdominal aortic aneurysm screening

S. A. Badger*, C. Jones, A. Murray, L. L. Lau, I. S. Young

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)
330 Downloads (Pure)

Abstract

Introduction
Evidence supports the introduction of an abdominal aortic aneurysm (AAA) screening programme. The aims of this study were to estimate future disease patterns and to determine the effect of the proportion attending on the programme’s cost-effectiveness.

Patients and methods
The results of the local AAA screening programme were reviewed. Ultrasonic infrarenal aortic diameter of 30 mm was considered aneurysmal. Projected population numbers from the Department of Health and current disease prevalence were used to estimate future number of potential patients. The Multi-centre Aneurysm Screening Study (MASS) Markov model was used to calculate an incremental cost-effectiveness ratio (ICER) and 95% uncertainty intervals (UI), using a 30-year time horizon and 3.5% per annum discount, to determine the effect of attendance.

Results
Men were recruited from August 2004 to May 2010. 13316 were invited for a scan and 5931 (44.5%) attended. 321 AAA were diagnosed, giving a prevalence of 5.4%, while 27 large AAA (0.46%) were repaired. The annual incidence of AAA until 2021 will range from 441 to 526, with an incidence of 40–48 large AAA, with both showing a gradual increase with time. Using this attendance rate, the ICER was calculated at £2350 per life-year gained (95% UI: £1620–£4290), or £3020 per quality-adjusted life-year gained (95% UI: £2080–£5500).

Conclusions
The prevalence of disease in this local AAA screening was similar to other studies. The low attendance will result in many AAA being missed, but will not impact greatly on the long-term cost-effectiveness.

Original languageEnglish
Pages (from-to)434-439
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume42
Issue number4
Early online date20 Apr 2011
DOIs
Publication statusPublished - 01 Oct 2011

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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