Aims: Bicuspid aortic valve (BAV) is the commonest congenital heart valve malformation, and is associated with life-threatening complications. Given the high heritability index of BAV, many experts recommend echocardiography screening for first-degree relatives (FDRs) of an index case. Here, we aim to evaluate the cost-effectiveness of such cascade screening for BAV.
Methods And Results: Using a decision-analytic model, we performed a cost-effectiveness analysis of echocardiographic screening for FDRs of a BAV index case. Data on BAV probabilities and complications among FDRs were derived from our institution's BAV familial cohort and from the literature on population-based BAV cohorts with long-term follow-up. Health gain was measured as quality-adjusted life years (QALYs). Cost inputs were based on list prices and literature data. One-way and probabilistic sensitivity analyses were performed to account for uncertainty in the model's variables. Screening of FDRs was found to be the dominant strategy, being more effective and less costly than no screening, with savings of €644 and gains of 0.3 QALY. Results were sensitive throughout the range of the main model's variables, including the full range of reported BAV rates among FDRs across the literature. A gradual decrease of the incremental effect was found with the increase in screening age.
Conclusion: This economic evaluation model found that echocardiographic screening of FDRs of a BAV index case is not only clinically important but also cost-effective and cost-saving. Sensitivity analysis supported the model's robustness, suggesting its generalization.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ehjqcco/qcab047 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Global Prevalence and Clinical Manifestations of Celiac Disease Among First-Degree Relatives: A Systematic Review and Meta-Analysis.
Am J Gastroenterol
November 2024
Celiac Disease and Gluten Related Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Article Synopsis
- First-degree relatives (FDRs) of celiac disease (CeD) patients are at a higher risk of developing the condition, with a systematic review analyzing the prevalence and symptoms using the anti-tissue transglutaminase antibody test.
- From 34 studies involving over 10,000 FDRs, the research found a seroprevalence of 11% and a biopsy-confirmed prevalence of 7%, with daughters and sisters showing the highest rates.
- The study suggests that about 1 in 14 FDRs may have CeD, emphasizing the need for routine screening to aid in early detection and management of the disease.
Family History of Colorectal Cancer and the Risk of Colorectal Neoplasia: A Systematic Review and Meta-Analysis.
Am J Gastroenterol
October 2024
Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Introduction: Although there is enough pooled evidence supporting the positive association between family history of colorectal cancer (CRC) in first-degree relatives (FDRs) and the risk of CRC, synthesized data on its association with the risk of other colorectal neoplasia are lacking. Therefore, we aimed to systematically assess this issue.
Methods: We searched PubMed, Web of Science, and Embase from database inception through May 9, 2024, to identify observational studies investigating the association between family history of CRC in FDRs and the risk of colorectal neoplasia (excepting CRC).
Risk of Major Adverse Cardiovascular Outcomes in Families With MASLD: A Population-Based Multigenerational Cohort Study.
Circ Cardiovasc Qual Outcomes
November 2024
Department of Medical Epidemiology and Biostatistics (F.E., J. Sun, D.B., A.F., J.F.L.), Karolinska Institutet, Stockholm, Sweden.
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a risk factor for cardiovascular disease. However, whether family members of individuals with MASLD also share an increased cardiovascular risk is unknown.
Methods: We created a nationwide multigenerational cohort study identifying all family members of Swedish adults diagnosed with biopsy-proven MASLD (1969-2017) and of matched general population comparators (by age, sex, calendar year, and county of residence).
Development and validation of the Florey Dementia Risk Score web-based tool to screen for Alzheimer's disease in primary care.
EClinicalMedicine
October 2024
The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, 3052, Australia.
Background: It is estimated that ∼60% of people with Alzheimer's disease (AD) are undetected or undiagnosed, with higher rates of underdiagnosis in low-to middle-income areas with limited medical resources. To promote health equity, we have developed a web-based tool that utilizes easy-to-collect clinical data to enhance AD detection rate in primary care settings.
Methods: This study was leveraged on the data collected from participants of the Australian Imaging, Biomarker & Lifestyle (AIBL) study and the Religious Orders Study and Memory and Aging Project (ROSMAP).
Development and Validation of an Algorithm to Predict Stillbirth Gestational Age in Medicaid Billing Records.
Am J Epidemiol
September 2024
Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida, Gainesville, Florida.
Introduction: With Medicaid covering half of US pregnancies, Medicaid Analytic eXtract (MAX) provides a valuable data source to enrich understanding about stillbirth etiologies.
Objective: We developed and validated a claims-based algorithm to predict GA at stillbirth.
Method: We linked the stillbirths identified in MAX 1999-2013 to Florida Fetal Death Records (FDRs) to obtain clinical estimates of GA (N=825).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!