ArticleLancet (London, England)2018
Analysis of clinical benefit, harms, and cost-effectiveness of screening women for abdominal aortic aneurysm.
Article in Lancet (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05346289 (Elective Treatment Rates Among Patients With Intact Abdominal Aortic Aneurysms -Patient- and Aneurysm-related Factors as Determinants of Surgical Non-eligibility in Women and Men), which is not on this map. Cited by 25 papers, 2 of them syntheses that pooled it.
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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.
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.
Elective Treatment Rates Among Patients With Intact Abdominal Aortic Aneurysms -Patient- and Aneurysm-related Factors as Determinants of Surgical Non-eligibility in Women and Men
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- Health Economic Research Assessing the Value of Early Detection of Cardiovascular Disease: A Systematic Review.PharmacoEconomics · 2023Pooled it
- Pooled it
- AI-Based screening for thoracic aortic aneurysms in routine breast MRI.Nature communications · 2025Article
- Impact of patient sex on selection for abdominal aortic aneurysm repair: a discrete choice experiment.BMJ open · 2025Article
- Novel insights into the association between organ damage and inflammatory response in preoperative abdominal aortic aneurysms.Frontiers in cardiovascular medicine · 2025Article
- Evaluating the cost-effectiveness of polygenic risk score-stratified screening for abdominal aortic aneurysm.Nature communications · 2024Article
- Aortic Size Index Versus Aortic Diameter in the Prediction of Rupture in Women With Abdominal Aortic Aneurysm.Cureus · 2024Review
- One-time screening for abdominal aortic aneurysm in Ontario, Canada: a model-based cost-utility analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Prevalence of abdominal aortic aneurysm (AAA) in first-degree relatives: detecting AAA in adult offspring of AAA patients.BJS open · 2024Article
- Trends in Abdominal Aortic Aneurysm Repair Incidence, Comorbidity, Treatment, and Mortality: A Danish Nationwide Cohort Study, 1996-2018.Clinical epidemiology · 2024Article
- Thoracoabdominal aortic aneurysm in women: many questions remain regarding their poor outcome.Annals of cardiothoracic surgery · 2023Review
- Artificial Intelligence Application to Screen Abdominal Aortic Aneurysm Using Computed tomography Angiography.Journal of digital imaging · 2023Article
- Overview of screening eligibility in patients undergoing ruptured AAA repair from 2003 to 2019 in the Vascular Quality Initiative.Journal of vascular surgery · 2022Observational
- AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis.Biomedicines · 2022Review
- Abdominal Aortic Aneurysm: Natural History, Pathophysiology and Translational Perspectives.Translational medicine @ UniSa · 2022Review
- Ultrasound screening for abdominal aortic aneurysm in high-risk women.The British journal of surgery · 2021Article
- Sex-specific normal values and determinants of infrarenal abdominal aortic diameter among non-aneurysmal elderly population.Scientific reports · 2021Article
- Derivation and Validation of a 10-Year Risk Score for Symptomatic Abdominal Aortic Aneurysm: Cohort Study of Nearly 500 000 Individuals.Circulation · 2021Article
- Epidemiology of endovascular and open repair for abdominal aortic aneurysms in the United States from 2004 to 2015 and implications for screening.Journal of vascular surgery · 2021Article
- Sex Differences in Rupture Risk and Mortality in Untreated Patients With Intact Abdominal Aortic Aneurysms.Journal of the American Heart Association · 2021Article
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundA third of deaths in the UK from ruptured abdominal aortic aneurysm (AAA) are in women. In men, national screening programmes reduce deaths from AAA and are cost-effective. The benefits, harms, and cost-effectiveness in offering a similar programme to women have not been formally assessed, and this was the aim of this study.
methodsWe developed a decision model to assess predefined outcomes of death caused by AAA, life years, quality-adjusted life years, costs, and the incremental cost-effectiveness ratio for a population of women invited to AAA screening versus a population who were not invited to screening. A discrete event simulation model was set up for AAA screening, surveillance, and intervention. Relevant women-specific parameters were obtained from sources including systematic literature reviews, national registry or administrative databases, major AAA surgery trials, and UK National Health Service reference costs.
findingsAAA screening for women, as currently offered to UK men (at age 65 years, with an AAA diagnosis at an aortic diameter of ≥3·0 cm, and elective repair considered at ≥5·5cm) gave, over 30 years, an estimated incremental cost-effectiveness ratio of £30 000 (95% CI 12 000-87 000) per quality-adjusted life year gained, with 3900 invitations to screening required to prevent one AAA-related death and an overdiagnosis rate of 33%. A modified option for women (screening at age 70 years, diagnosis at 2·5 cm and repair at 5·0 cm) was estimated to have an incremental cost-effectiveness ratio of £23 000 (9500-71 000) per quality-adjusted life year and 1800 invitations to screening required to prevent one AAA-death, but an overdiagnosis rate of 55%. There was considerable uncertainty in the cost-effectiveness ratio, largely driven by uncertainty about AAA prevalence, the distribution of aortic sizes for women at different ages, and the effect of screening on quality of life.
interpretationBy UK standards, an AAA screening programme for women, designed to be similar to that used to screen men, is unlikely to be cost-effective. Further research on the aortic diameter distribution in women and potential quality of life decrements associated with screening are needed to assess the full benefits and harms of modified options.
fundingUK National Institute for Health Research Health Technology Assessment programme.
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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.