Evidence map›Paper›PMID 36102774›Full record

Observational studyThe lancet. Healthy longevity2022

Counting the cost of premature mortality with progressively worse aortic stenosis in Australia: a clinical cohort study.

Simon Stewart, Clifford Afoakwah, Yih-Kai Chan, Jordan B Strom, David Playford, Geoffrey A Strange

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The lancet. Healthy longevity, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
5.3field-weighted citation impact, top 3% 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

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
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  6. Cost-effectiveness of population screening for aortic stenosis.European heart journal. Quality of care & clinical outcomes · 2025
    Article
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  10. A Narrative Review of the Evidence for Transcatheter Aortic Valve Implants.Journal of cardiovascular development and disease · 2025
    Review
  11. The influence of lipoprotein(a) on aortic valve calcification in patients undergoing transcatheter aortic valve replacement.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 6 institutions in 3 countries.

Simon StewartInstitute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia; School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia. Electronic address: simon.stewart@nd.edu.au.
Clifford AfoakwahCentre for Applied Health Economics, Griffith University, Brisbane, QLD, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Torrens University Australia, Adelaide, SA, Australia.
Yih-Kai ChanMary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
Jordan B StromRichard A And Susan F Smith Centre for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Centre, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
David PlayfordInstitute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.
Geoffrey A StrangeInstitute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Australian Catholic University · AUDeaconess Hospital · USGriffith University · AUThe University of Notre Dame Australia · AUTorrens University Australia · AUUniversity of Sydney · AU

Funding

Chronic Renal Insufficiency and Silent Progression of Aortic Stenosis (CRISP-AS)R01HL169517 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Jordan Blair Strom · 2023 to 2026
$3.1M
Identification of the Components of Frailty Using Administrative Data and Metabolite ProfilingK23HL144907 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI STROM, JORDAN BLAIR · 2019 to 2023
$1.0M
NHLBI NIH HHS K23 HL144907NHLBI NIH HHS R01 HL169517
6 · The paper itself

Abstract

backgroundAortic stenosis is the most common cardiac valve disorder requiring clinical management. However, there is little evidence on the societal cost of progressive aortic stenosis. We sought to quantify the societal burden of premature mortality associated with progressively worse aortic stenosis.

methodsIn this observational clinical cohort study, we examined echocardiograms on native aortic valves of 98 565 men and 99 357 women aged 65 years or older across 23 sites in Australia, from Jan 1, 2003, to Dec 31, 2017. Individuals were grouped according to their peak aortic valve velocity in 0·50 m/s increments up to 4·00 m/s or more (severe aortic stenosis), using 1·00-1·99 m/s (no aortic stenosis) as the reference group. Sex-specific premature mortality and years of life lost during a 5-year follow-up were calculated, along with willingness-to-pay to regain quality-adjusted life years (QALYs).

findingsOverall, 20 701 (21·0%) men and 18 576 (18·7%) women had evidence of mild-to-severe aortic stenosis. The actual 5-year mortality in men with normal aortic valves was 32·1% and in women was 26·1%, increasing to 40·9% (mild aortic stenosis) and 52·2% (severe aortic stenosis) in men and to 35·9% (mild aortic stenosis) and 55·3% (severe aortic stenosis) in women. Overall, the estimated societal cost of premature mortality associated with aortic stenosis was AU$629 million in men and $735 million in women. Per 1000 men and women investigated, aortic stenosis was associated with eight more premature deaths in men resulting in 32·5 more QALYs lost (societal cost of $1·40 million) and 12 more premature deaths in women resulting in 57·5 more QALYs lost (societal cost of $2·48 million) when compared with those without aortic stenosis.

interpretationAny degree of aortic stenosis in older individuals is associated with premature mortality and QALYs. In this context, there is a crucial need for cost-effective strategies to promptly detect and optimally manage this common condition within our ageing populations.

fundingEdwards LifeSciences, National Health and Medical Research Council of Australia, and the National Heart, Lung, and Blood Institute.

Indexed as

Aortic Valve StenosisMortality, PrematureAgedAortic ValveCohort StudiesConstriction, PathologicFemaleHumansMale

Identifiers

PMID36102774
PMCPMC9484033
OpenAlexW4295045780

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.