Cost-effectiveness of targeted screening for abdominal aortic aneurysm

Monte-Carlo based estimates

Tuomo Pentikäinen, Teemu Sipilä, Pekka Rissanen, Sari Soisalon-Soininen, Jarmo Salo

Research output: Contribution to journalArticleScientificpeer-review

12 Citations (Scopus)

Abstract

Objectives: This article reports a cost-effectiveness analysis of targeted screening for abdominal aortic aneurysm (AAA). A major emphasis was on the estimation of distributions of costs and effectiveness.

Methods: We performed a Monte Carlo simulation using C programming language in a PC environment. Data on survival and costs, and a majority of screening probabilities, were from our own empirical studies. Natural history data were based on the literature.

Results: Each screened male gained 0.07 life-years at an incremental cost of FIM 3,300. The expected values differed from zero very significantly. For females, expected gains were 0.02 life-years at an incremental cost of FIM 1,100, which was not statistically significant. Cost-effectiveness ratios and their 95% confidence intervals were FIM 48,000 (27,000–121,000) and 54,000 (22,000–∞) for males and females, respectively. Sensitivity analysis revealed that the results for males were stable. Individual variation in life-year gains was high.

Conclusions: Males seemed to benefit from targeted AAA screening, and the results were stable. As far as the cost-effectiveness ratio is considered acceptable, screening for males seemed to be justified. However, our assumptions about growth and rupture behavior of AAAs might be improved with further clinical and epidemiological studies. As a point estimate, females benefited in a similar manner, but the results were not statistically significant. The evidence of this study did not justify screening of females.

Original languageEnglish
Pages (from-to)22 - 34
Number of pages13
JournalInternational Journal of Technology Assessment in Health Care
Volume16
Issue number1
Publication statusPublished - 2000
MoE publication typeA1 Journal article-refereed

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Abdominal Aortic Aneurysm
Cost-Benefit Analysis
Costs and Cost Analysis
Epidemiologic Studies
Rupture
Confidence Intervals
Growth

Cite this

Pentikäinen, T., Sipilä, T., Rissanen, P., Soisalon-Soininen, S., & Salo, J. (2000). Cost-effectiveness of targeted screening for abdominal aortic aneurysm: Monte-Carlo based estimates. International Journal of Technology Assessment in Health Care, 16(1), 22 - 34.
Pentikäinen, Tuomo ; Sipilä, Teemu ; Rissanen, Pekka ; Soisalon-Soininen, Sari ; Salo, Jarmo. / Cost-effectiveness of targeted screening for abdominal aortic aneurysm : Monte-Carlo based estimates. In: International Journal of Technology Assessment in Health Care. 2000 ; Vol. 16, No. 1. pp. 22 - 34.
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abstract = "Objectives: This article reports a cost-effectiveness analysis of targeted screening for abdominal aortic aneurysm (AAA). A major emphasis was on the estimation of distributions of costs and effectiveness.Methods: We performed a Monte Carlo simulation using C programming language in a PC environment. Data on survival and costs, and a majority of screening probabilities, were from our own empirical studies. Natural history data were based on the literature.Results: Each screened male gained 0.07 life-years at an incremental cost of FIM 3,300. The expected values differed from zero very significantly. For females, expected gains were 0.02 life-years at an incremental cost of FIM 1,100, which was not statistically significant. Cost-effectiveness ratios and their 95{\%} confidence intervals were FIM 48,000 (27,000–121,000) and 54,000 (22,000–∞) for males and females, respectively. Sensitivity analysis revealed that the results for males were stable. Individual variation in life-year gains was high.Conclusions: Males seemed to benefit from targeted AAA screening, and the results were stable. As far as the cost-effectiveness ratio is considered acceptable, screening for males seemed to be justified. However, our assumptions about growth and rupture behavior of AAAs might be improved with further clinical and epidemiological studies. As a point estimate, females benefited in a similar manner, but the results were not statistically significant. The evidence of this study did not justify screening of females.",
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Pentikäinen, T, Sipilä, T, Rissanen, P, Soisalon-Soininen, S & Salo, J 2000, 'Cost-effectiveness of targeted screening for abdominal aortic aneurysm: Monte-Carlo based estimates', International Journal of Technology Assessment in Health Care, vol. 16, no. 1, pp. 22 - 34.

Cost-effectiveness of targeted screening for abdominal aortic aneurysm : Monte-Carlo based estimates. / Pentikäinen, Tuomo; Sipilä, Teemu; Rissanen, Pekka; Soisalon-Soininen, Sari; Salo, Jarmo.

In: International Journal of Technology Assessment in Health Care, Vol. 16, No. 1, 2000, p. 22 - 34.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Cost-effectiveness of targeted screening for abdominal aortic aneurysm

T2 - Monte-Carlo based estimates

AU - Pentikäinen, Tuomo

AU - Sipilä, Teemu

AU - Rissanen, Pekka

AU - Soisalon-Soininen, Sari

AU - Salo, Jarmo

PY - 2000

Y1 - 2000

N2 - Objectives: This article reports a cost-effectiveness analysis of targeted screening for abdominal aortic aneurysm (AAA). A major emphasis was on the estimation of distributions of costs and effectiveness.Methods: We performed a Monte Carlo simulation using C programming language in a PC environment. Data on survival and costs, and a majority of screening probabilities, were from our own empirical studies. Natural history data were based on the literature.Results: Each screened male gained 0.07 life-years at an incremental cost of FIM 3,300. The expected values differed from zero very significantly. For females, expected gains were 0.02 life-years at an incremental cost of FIM 1,100, which was not statistically significant. Cost-effectiveness ratios and their 95% confidence intervals were FIM 48,000 (27,000–121,000) and 54,000 (22,000–∞) for males and females, respectively. Sensitivity analysis revealed that the results for males were stable. Individual variation in life-year gains was high.Conclusions: Males seemed to benefit from targeted AAA screening, and the results were stable. As far as the cost-effectiveness ratio is considered acceptable, screening for males seemed to be justified. However, our assumptions about growth and rupture behavior of AAAs might be improved with further clinical and epidemiological studies. As a point estimate, females benefited in a similar manner, but the results were not statistically significant. The evidence of this study did not justify screening of females.

AB - Objectives: This article reports a cost-effectiveness analysis of targeted screening for abdominal aortic aneurysm (AAA). A major emphasis was on the estimation of distributions of costs and effectiveness.Methods: We performed a Monte Carlo simulation using C programming language in a PC environment. Data on survival and costs, and a majority of screening probabilities, were from our own empirical studies. Natural history data were based on the literature.Results: Each screened male gained 0.07 life-years at an incremental cost of FIM 3,300. The expected values differed from zero very significantly. For females, expected gains were 0.02 life-years at an incremental cost of FIM 1,100, which was not statistically significant. Cost-effectiveness ratios and their 95% confidence intervals were FIM 48,000 (27,000–121,000) and 54,000 (22,000–∞) for males and females, respectively. Sensitivity analysis revealed that the results for males were stable. Individual variation in life-year gains was high.Conclusions: Males seemed to benefit from targeted AAA screening, and the results were stable. As far as the cost-effectiveness ratio is considered acceptable, screening for males seemed to be justified. However, our assumptions about growth and rupture behavior of AAAs might be improved with further clinical and epidemiological studies. As a point estimate, females benefited in a similar manner, but the results were not statistically significant. The evidence of this study did not justify screening of females.

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JO - International Journal of Technology Assessment in Health Care

JF - International Journal of Technology Assessment in Health Care

SN - 0266-4623

IS - 1

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