Cost-effectiveness and screening performance of ECG handheld machine in a population screening programme: The Belgian Heart Rhythm Week screening programme

Proietti, Marco ORCID: 0000-0003-1452-2478, Farcomeni, Alessio, Goethals, Peter, Scavee, Christophe, Vijgen, Johan, Blankoff, Ivan, Vandekerckhove, Yves, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Mairesse, Georges H (2019) Cost-effectiveness and screening performance of ECG handheld machine in a population screening programme: The Belgian Heart Rhythm Week screening programme. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 26 (9). pp. 964-972.

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Abstract

<h4>Aims</h4>Overall, 40% of patients with atrial fibrillation are asymptomatic. The usefulness and cost-effectiveness of atrial fibrillation screening programmes are debated. We evaluated whether an atrial fibrillation screening programme with a handheld electrocardiogram (ECG) machine in a population-wide cohort has a high screening yield and is cost-effective.<h4>Methods</h4>We used a Markov-model based modelling analysis on 1000 hypothetical individuals who matched the Belgian Heart Rhythm Week screening programme. Subgroup analyses of subjects ≥65 and ≥75 years old were performed. Screening was performed with one-lead ECG handheld machine Omron® HeartScan HCG-801.<h4>Results</h4>In both overall population and subgroups, the use of the screening procedure diagnosed a consistently higher number of diagnosed atrial fibrillation than not screening. In the base-case scenario, the screening procedure resulted in 106.6 more atrial fibrillation patient-years, resulting in three fewer strokes, 10 more life years and five more quality-adjusted life years (QALYs). The number needed-to-screen (NNS) to avoid one stroke was 361. In subjects ≥65 years old, we found 80.8 more atrial fibrillation patient-years, resulting in three fewer strokes, four more life-years and five more QALYs. The NNS to avoid one stroke was 354. Similar results were obtained in subjects ≥75 years old, with a NNS to avoid one stroke of 371. In the overall population, the incremental cost-effectiveness ratio for any gained QALY showed that the screening procedure was cost-effective in all groups.<h4>Conclusions</h4>In a population-wide screening cohort, the use of a handheld ECG machine to identify subjects with newly diagnosed atrial fibrillation was cost-effective in the general population, as well as in subjects ≥65 and subjects ≥75 years old.

Item Type:	Article
Uncontrolled Keywords:	Atrial fibrillation, screening, outcomes, cost-effectiveness analysis
Depositing User:	Symplectic Admin
Date Deposited:	10 Apr 2019 09:58
Last Modified:	06 Feb 2024 08:34
DOI:	10.1177/2047487319839184
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3036342