Lawson, K.D., Fenwick, E.A.L., Pell, A.C.H., and Pell, J.P. (2010) Comparison of mass and targeted screening strategies for cardiovascular risk: simulation of the effectiveness, cost-effectiveness and coverage using a cross-sectional survey of 3921 people. Heart, 96 (3). pp. 208-212.

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Abstract

Background: Cardiovascular primary prevention should be targeted at those with the highest global risk. However, it is unclear how best to identify such individuals from the general population. The aim of this study was to compare mass and targeted screening strategies in terms of effectiveness, cost effectiveness and coverage.

Methods: The Scottish Health Survey provided cross-sectional data on 3921 asymptomatic members of the general population aged 40–74 years. We undertook simulation models of five screening strategies: mass screening, targeted screening of deprived communities, targeted screening of family members and combinations of the latter two.

Results: To identify one individual at high risk of premature cardiovascular disease using mass screening required 16.0 people to be screened at a cost of £370. Screening deprived communities targeted 17% of the general population but identified 45% of those at high risk, and identified one high-risk individual for every 6.1 people screened at a cost of £141. Screening family members targeted 28% of the general population but identified 61% of those at high risk, and identified one high-risk individual for every 7.4 people screened at a cost of £170. Combining both approaches enabled 84% of high risk individuals to be identified by screening only 41% of the population. Extending targeted to mass screening identified only one additional high-risk person for every 58.8 screened at a cost of £1358.

Conclusions: Targeted screening strategies are less costly than mass screening, and can identify up to 84% of high-risk individuals. The additional resources required for mass screening may not be justified.

Item ID:	36988
Item Type:	Article (Research - C1)
ISSN:	1468-201X
Date Deposited:	26 Feb 2015 02:33
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110399 Clinical Sciences not elsewhere classified @ 50% 14 ECONOMICS > 1402 Applied Economics > 140208 Health Economics @ 50%
SEO Codes:	92 HEALTH > 9202 Health and Support Services > 920206 Health Policy Economic Outcomes @ 34% 92 HEALTH > 9202 Health and Support Services > 920207 Health Policy Evaluation @ 33% 92 HEALTH > 9202 Health and Support Services > 920208 Health Inequalities @ 33%
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