ArticleThorax2019
Model-based evaluation of the long-term cost-effectiveness of systematic case-finding for COPD in primary care.
Article in Thorax, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Economic evaluations of screening and case-finding for Chronic Obstructive Pulmonary Disease (COPD): a systematic review.NPJ primary care respiratory medicine · 2026Pooled it
- Cost-effectiveness of screening for chronic obstructive pulmonary disease: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Undiagnosed and 'overdiagnosed' COPD using postbronchodilator spirometry in primary healthcare settings: a systematic review and meta-analysis.BMJ open respiratory research · 2023Pooled it
- Cost-effectiveness of a self-management maintenance programme following pulmonary rehabilitation: a UK randomised controlled trial for patients with chronic obstructive pulmonary disease.BMJ open respiratory research · 2025Trial
- Development and Validation of an Electronic Health Record Algorithm to Predict the Presence of Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary disease · 2026Article
- Pragmatic Evaluation of an Improvement Program for People Living With Modifiable High-Risk COPD Versus Usual Care: Protocols for the Cluster Randomized PREVAIL Trial.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025Article
- Cost-effectiveness of chronic obstructive pulmonary disease population screening in China: based on individual data from WHO Collaborating Centre-initiated 'Enjoying Breathing Program'.BMC public health · 2025Article
- Article
- Treatment patterns for chronic obstructive pulmonary disease under the tiered medical system.Scientific reports · 2025Article
- Economic Burden of Chronic Obstructive Pulmonary Disease: A Systematic Review.Tuberculosis and respiratory diseases · 2024Article
- Cost-effectiveness of population-based screening for chronic obstructive pulmonary disease in China: a simulation modeling study.The Lancet regional health. Western Pacific · 2024Article
- Early Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease: The Costs and Benefits of Case Finding.American journal of respiratory and critical care medicine · 2024Article
- The value of blood-based measures of liver function and urate in lung cancer risk prediction: A cohort study and health economic analysis.Cancer epidemiology · 2023Article
- Estimating the Health and Economic Impact of Improved Management in Prevalent Chronic Obstructive Pulmonary Disease Populations in England, Germany, Canada, and Japan: A Modelling Study.International journal of chronic obstructive pulmonary disease · 2023Article
- Current Progress of COPD Early Detection: Key Points and Novel Strategies.International journal of chronic obstructive pulmonary disease · 2023Review
- Estimating the Prevalence of AATD Patients in the UK to Identify Underdiagnosis and Determine the Eligibility for Potential Augmentation Therapy.International journal of chronic obstructive pulmonary disease · 2023Article
- Accuracy and economic evaluation of screening tests for undiagnosed COPD among hypertensive individuals in Brazil.NPJ primary care respiratory medicine · 2022Article
- Article
- Ten-year prediction model for post-bronchodilator airflow obstruction and early detection of COPD: development and validation in two middle-aged population-based cohorts.BMJ open respiratory research · 2021Article
- Cost-effectiveness analysis of COPD screening programs in primary care for high-risk patients in China.NPJ primary care respiratory medicine · 2021Article
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Authors and funding
19 authors.
Funding
Abstract
introduction'One-off' systematic case-finding for COPD using a respiratory screening questionnaire is more effective and cost-effective than routine care at identifying new cases. However, it is not known whether early diagnosis and treatment is beneficial in the longer term. We estimated the long-term cost-effectiveness of a regular case-finding programme in primary care.
methodsA Markov decision analytic model was developed to compare the cost-effectiveness of a 3-yearly systematic case-finding programme targeted to ever smokers aged ≥50 years with the current routine diagnostic process in UK primary care. Patient-level data on case-finding pathways was obtained from a large randomised controlled trial. Information on the natural history of COPD and treatment effects was obtained from a linked COPD cohort, UK primary care database and published literature. The discounted lifetime cost per quality-adjusted life-year (QALY) gained was calculated from a health service perspective.
resultsThe incremental cost-effectiveness ratio of systematic case-finding versus current care was £16 596 per additional QALY gained, with a 78% probability of cost-effectiveness at a £20 000 per QALY willingness-to-pay threshold. The base case result was robust to multiple one-way sensitivity analyses. The main drivers were response rate to the initial screening questionnaire and attendance rate for the confirmatory spirometry test. DISCUSSION: Regular systematic case-finding for COPD using a screening questionnaire in primary care is likely to be cost-effective in the long-term despite uncertainties in treatment effectiveness. Further knowledge of the natural history of case-found patients and the effectiveness of their management will improve confidence to implement such an approach.
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