Atrial Fibrillation Screening Program Cost-Effective in Elderly

WEDNESDAY, Nov. 16, 2022 (HealthDay News) — A broad atrial fibrillation (AF) screening program is cost-effective in an elderly population, according to a study published online Nov. 9 in the European Heart Journal.

Johan Lyth, M.D., from Linköping University in Sweden, and colleagues estimated the cost-effectiveness of population-based screening for AF using clinical outcomes. The prevalence of AF, use of oral anticoagulation, clinical event data, and all-cause mortality were extracted from the STROKESTOP randomized study, involving 27,975 persons aged 75 or 76 years who were randomly assigned into a screening and control group.

The researchers found 77 life years gained and 65 quality-adjusted life years gained per 1,000 individuals invited to screening. In the screening invitation group, the incremental cost was €1.77 million lower. The gain in quality-adjusted life years at a lower cost indicated that the screening strategy was dominant. Based on the results from 10,000 Monte Carlo simulations, the AF screening strategy was cost-effective in 99.2 percent of the simulations and cost-saving in 92.7 percent. Screening of 1,000 individuals resulted in 10.6 fewer strokes, 1.0 more case of systemic embolism, and 2.9 fewer bleeds associated with hospitalization in the base-case scenario.

“The implication of this study is that population-based AF screening for 75/76-year-old individuals is cost-effective at a probability of 99.2 percent and cost-saving at a probability of 92.7 percent and should therefore be implemented,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text