Henriksson M, Lundgren F
Centre for Medical Technology Assessment, Linköping University, Linköping, Sweden.
Br J Surg. 2005 Aug;92(8):976-83. doi: 10.1002/bjs.5122.
Abdominal aortic aneurysm (AAA) causes about 2 per cent of all deaths in men over the age of 65 years. A major improvement in operative mortality would have little impact on total mortality, so screening for AAA has been recommended as a solution. The cost-effectiveness of a programme that invited 65-year-old men for ultrasonographic screening was compared with current clinical practice in a decision-analytical model.
In a probabilistic Markov model, costs and health outcomes of a screening programme and current clinical practice were simulated over a lifetime perspective. To populate the model with the best available evidence, data from published papers, vascular databases and primary research were used.
The results of the base-case analysis showed that the incremental cost per gained life-year for a screening programme compared with current practice was 7760, and that for a quality-adjusted life-year was 9700. The probability of screening being cost-effective was high.
A financially and practically feasible screening programme for AAA, in which men are invited for ultrasonography in the year in which they turn 65, appears to yield positive health outcomes at a reasonable cost.
腹主动脉瘤（AAA）导致65岁以上男性约2%的死亡。手术死亡率的大幅改善对总死亡率影响不大，因此推荐对腹主动脉瘤进行筛查作为解决方案。在一个决策分析模型中，将邀请65岁男性进行超声筛查项目的成本效益与当前临床实践进行了比较。
在一个概率马尔可夫模型中，从终生角度模拟了筛查项目和当前临床实践的成本及健康结果。为用最佳现有证据填充模型，使用了已发表论文、血管数据库和初步研究的数据。
基础病例分析结果显示，与当前实践相比，筛查项目每获得一个生命年的增量成本为7760，每获得一个质量调整生命年的增量成本为9700。筛查具有成本效益的概率很高。
一项针对腹主动脉瘤的经济且可行的筛查项目，即邀请65岁男性在其65岁当年进行超声检查，似乎能以合理成本产生积极的健康结果。
