Evidence map›Paper›PMID 28835370›Full record

ArticleCMAJ open2017

Screening for atrial fibrillation in Canadian pharmacies: an economic evaluation.

Jean-Eric Tarride, Lisa Dolovich, Gordon Blackhouse, Jason Robert Guertin, Natasha Burke, Veena Manja, Alex Grinvalds, Ting Lim, Jeff S Healey, Roopinder K Sandhu

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Review
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Jean-Eric TarrideAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Lisa DolovichAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Gordon BlackhouseAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Jason Robert GuertinAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Natasha BurkeAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Veena ManjaAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Alex GrinvaldsAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Ting LimAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Jeff S HealeyAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Roopinder K SandhuAffiliations: Departments of Health Research Methods, Evidence, and Impact (Tarride, Blackhouse, Burke, Dolovich) and Family Medicine (Dolovich), and Population Health Research Institute (Grinvalds, Lim, Healey), McMaster University; Programs for Assessment of Technology in Health (Tarride, Blackhouse, Burke, Dolovich), Research Institute of St. Joe's Hamilton, Hamilton, Ont.; Leslie Dan Faculty of Pharmacy (Dolovich), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Guertin), Université Laval; Centre de recherche du Centre hospitalier universitaire de Québec - Université Laval, Axe Santé des populations et pratiques optimales en santé (Guertin), Hôpital du Saint-Sacrement, Québec, Que.; Department of Internal Medicine (Manja), State University of New York at Buffalo; VA Western New York Healthcare System at Buffalo (Manja), Buffalo, NY; Division of Cardiology (Sandhu), University of Alberta, Edmonton, Alta.
Impact · CAUniversité Laval · CAPopulation Health Research Institute · CAUniversity at Buffalo, State University of New York · USVA Western New York Healthcare System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundScreening for undiagnosed atrial fibrillation may lead to treatment with oral anticoagulation therapy, which can decrease the risk of ischemic stroke. The objective of this study was to conduct an economic evaluation of the Program for the Identification of 'Actionable' Atrial Fibrillation in the Pharmacy Setting (PIAAF-Pharmacy), which screened 1145 participants aged 65 years or more at 30 community pharmacies in Ontario and Alberta between October 2014 and April 2015.

methodsWe used a 2-part decision model to evaluate the short- and long-term costs and quality-adjusted life-years (QALYs) of a pharmacy screening program for atrial fibrillation compared to no screening. Data from the PIAAF-Pharmacy study were used for the short-term model, and the relevant literature was used to extrapolate the benefits of the PIAAF-Pharmacy study in the long-term model. Costs and QALYs were calculated from a payer perspective over a lifetime horizon and were discounted at 1.5%/year.

resultsScreening for atrial fibrillation in pharmacies was associated with higher costs ($26) and more QALYs (0.0035) compared to no screening, yielding an incremental cost per QALY gained of $7480. Univariate and probabilistic sensitivity analyses confirmed that screening for atrial fibrillation in a pharmacy setting was a cost-effective strategy.

interpretationOur results support screening for atrial fibrillation in Canadian pharmacies. Given this finding, efforts should be made by provincial governments and pharmacies to implement such programs in Canada. The addition of atrial fibrillation screening alongside screening and management of other cardiovascular conditions may help to reduce the burden of stroke.

Identifiers

PMID28835370
PMCPMC5621947
OpenAlexW2750038053

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.