Department of Medical and Health Sciences, Centre for Medical Technology Assessment, Linkoping University, SE-581 83 Linkoping, Sweden
Karolinska Institutet, Department of Clinical Science, Cardiology Unit, Danderyd University Hospital, Stockholm, Sweden.
Europace. 2015 Jul;17(7):1023-9. doi: 10.1093/europace/euv083. Epub 2015 Apr 12.
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.
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.
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.
本研究旨在评估对 75/76 岁无症状心房颤动（AF）患者进行 2 周间歇性筛查的成本效益。
对 75 岁个体进行筛查的成本效益分析基于终身决策分析马尔可夫模型。在该模型中，模拟了 1000 名与 STROKESTOP 研究人群相匹配的假设个体。该模型分析了不同参数的人群，如患病率、AF 状态、口服抗凝治疗、中风风险、效用和成本。在基本情况下，对 1000 名个体进行筛查可减少 263 个未发现的 AF 患者年数。这意味着每 1000 名筛查个体可减少 8 次中风、多 11 年的生命年和多 12 个质量调整生命年（QALY）。筛查的增量成本为 50012 欧元，导致每获得一个 QALY 的成本为 4313 欧元，每避免一次中风的成本为 6583 欧元。
使用决策分析模拟模型，已经表明对 75/76 岁个体进行无症状 AF 筛查具有成本效益。
