liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
A cost-effectiveness analysis of screening for silent atrial fibrillation after ischaemic stroke.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
Department of Clinical Sciences, Danderyd Hospital, Division of cardiovascular medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Sciences, Danderyd Hospital, Division of cardiovascular medicine, Karolinska Institutet, Stockholm, Sweden.
Show others and affiliations
2015 (English)In: Europace, ISSN 1099-5129, E-ISSN 1532-2092, Vol. 17, no 2, 207-14 p.Article in journal (Refereed) Published
Abstract [en]

AIMS: The purpose of this study was to estimate the cost-effectiveness of two screening methods for detection of silent AF, intermittent electrocardiogram (ECG) recordings using a handheld recording device, at regular time intervals for 30 days, and short-term 24 h continuous Holter ECG, in comparison with a no-screening alternative in 75-year-old patients with a recent ischaemic stroke.

METHODS AND RESULTS: The long-term (20-year) costs and effects of all alternatives were estimated with a decision analytic model combining the result of a clinical study and epidemiological data from Sweden. The structure of a cost-effectiveness analysis was used in this study. The short-term decision tree model analysed the screening procedure until the onset of anticoagulant treatment. The second part of the decision model followed a Markov design, simulating the patients' health states for 20 years. Continuous 24 h ECG recording was inferior to intermittent ECG in terms of cost-effectiveness, due to both lower sensitivity and higher costs. The base-case analysis compared intermittent ECG screening with no screening of patients with recent stroke. The implementation of the screening programme on 1000 patients resulted over a 20-year period in 11 avoided strokes and the gain of 29 life-years, or 23 quality-adjusted life years, and cost savings of €55 400.

CONCLUSION: Screening of silent AF by intermittent ECG recordings in patients with a recent ischaemic stroke is a cost-effective use of health care resources saving costs and lives and improving the quality of life.

Place, publisher, year, edition, pages
Oxford University Press, 2015. Vol. 17, no 2, 207-14 p.
Keyword [en]
Atrial fibrillation; Cost-effectiveness; Ischaemic stroke; QALY; Screening; Secondary prevention
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-115381DOI: 10.1093/europace/euu213ISI: 000351601600008PubMedID: 25349228OAI: oai:DiVA.org:liu-115381DiVA: diva2:795131
Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2017-12-04

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Levin, Lars-ÅkeHusberg, MagnusDavidson, Thomas

Search in DiVA

By author/editor
Levin, Lars-ÅkeHusberg, MagnusDavidson, Thomas
By organisation
Division of Health Care AnalysisFaculty of Health Sciences
In the same journal
Europace
Health Care Service and Management, Health Policy and Services and Health Economy

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 110 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf