Centro de Investigación Biomédica en Red (CIBER) Cardiovascular, Department of Vascular Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain.
Universitat Autónoma de Barcelona, Barcelona, Spain.
Int Angiol. 2021 Feb;40(1):67-76. doi: 10.23736/S0392-9590.20.04547-2. Epub 2020 Oct 21.
Abdominal aortic aneurysm (AAA) is a silent, progressive disease that can lead to death. It is easily diagnosed with noninvasive methods and its routine treatment has excellent results. This creates an optimal situation for population screening programs. The aim of this paper was to assess results and methodological quality of cost-utility studies on screening versus no screening scenarios for AAA to assess future establishment of new AAA screening programs.
A systematic review of efficiency (cost-effectiveness and cost-utility) studies was performed, finally selecting cost-utility studies on AAA screening versus no screening. Papers were selected that dealt with efficiency of screening for AAA according to PICOTS framework and the methodological quality assessed according to the economic evaluation analyses described by Drummond and Caro. Two independent reviewers were involved in the procedure.
Research retrieved 88 studies. From those, 26 showed cost-effectiveness and cost-utility results. Finally, 10 studies had cost-utility results and suited criteria (published in the last 10 years; time-horizon: 10 years or more) for exhaustive analysis. All publications, except one, showed adequate incremental cost-utility ratios according to different national perspectives. Methodological assessment showed some quality limitations, but the majority of items analyzed were favorably answered after applying the questionnaires.
Confirmation of the cost-utility results in this revision at a national/regional level should be the basis for the implantation of new national screening programs worldwide. The methodological evaluation applied in this revision is crucial for the corresponding future piggy-back trials to assess routine application of national AAA screening programs.
腹主动脉瘤（AAA）是一种无声的、渐进性疾病，可导致死亡。它可以通过非侵入性方法轻松诊断，其常规治疗效果极佳。这为人群筛查计划创造了一个最佳环境。本文旨在评估 AAA 筛查与不筛查情况下的成本效益研究的结果和方法学质量，以评估未来建立新的 AAA 筛查计划的情况。
对效率（成本效益和成本效用）研究进行了系统评价，最终选择了 AAA 筛查与不筛查的成本效用研究。选择了根据 PICOTS 框架处理 AAA 筛查效率的论文，并根据 Drummond 和 Caro 描述的经济评估分析方法评估了方法学质量。两名独立的审查员参与了该过程。
研究共检索到 88 项研究。其中，26 项研究显示了成本效益和成本效用结果。最终，有 10 项研究具有成本效用结果，并且符合全面分析的标准（在过去 10 年内发表；时间范围：10 年或更长时间）。除了一项之外，所有出版物都根据不同的国家观点显示了足够的增量成本效用比。方法学评估显示出一些质量限制，但在应用问卷后，大多数分析项目都得到了有利的回答。
在国家/地区层面上对本次修订中的成本效用结果进行确认，应该是全球范围内建立新的国家筛查计划的基础。本修订中应用的方法学评估对于未来的配套临床试验至关重要，这些临床试验将评估国家 AAA 筛查计划的常规应用。
