Trial reportEuropean heart journal2023
Cost-effectiveness of population screening for atrial fibrillation: the STROKESTOP study.
Trial report in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses that pooled 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.
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
43 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trials.Annals of medicine · 2025Pooled it
- Screening for Atrial Fibrillation in Stroke Prevention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Reviews in cardiovascular medicine · 2025Pooled it
- Pooled it
- Population reach and participation rate in opportunistic vs. systematic atrial fibrillation screening: STROKESTOP III.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Trial
- Trial
- Closing Europe's Cardiovascular Implementation Gap: A Critical Review of the Safe Hearts Plan and the Cyprus Test Case.Journal of clinical medicine · 2026Review
- Atrial Fibrillation in Diabetes: Epidemiology, Mechanisms and Integrated Management.Journal of clinical medicine · 2026Review
- Screening for atrial fibrillation using an ECG monitoring patch among the elderly population in rural China: a single-arm study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Australian key stakeholder views regarding implementation of atrial fibrillation screening: a qualitative evaluation.BMJ open · 2026Article
- The cost-effectiveness of implantable loop recorder detection of atrial fibrillation to prevent stroke in persons at high risk: An economic evaluation alongside a multicentre randomised controlled trial in Denmark (The LOOP Study).The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Health economic simulation modeling of an AI-enabled clinical decision support system for coronary revascularization.NPJ digital medicine · 2026Article
- Recent-onset atrial fibrillation: challenges and opportunities.European heart journal · 2026Review
- Cost-effectiveness of atrial fibrillation screening programmes across European nations.European heart journal. Quality of care & clinical outcomes · 2026Article
- Exploring nurse- and allied health professional-led opportunistic atrial fibrillation screening with artificial intelligence-enabled devices in community and primary care.Frontiers in cardiovascular medicine · 2026Review
- Predicting Incident Atrial Fibrillation after Stroke: A Scoping Review of Clinical Scores, Biomarkers, and AI-Enhanced Strategies.Cerebrovascular diseases extra · 2026Article
- Clinical implications of the recalibrated CHA₂DS₂-VA score for women after ischemic stroke: a prospective cohort study.Acta neurologica Belgica · 2025Observational
- Brazilian Atrial Fibrillation Guidelines - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Universal Atrial Fibrillation Screening Using Electrocardiographic Artificial Intelligence: A Cost-Effective Approach in Rural Communities.Journal of medical systems · 2025Article
- Cost-effectiveness of a clinical decision support system for atrial fibrillation: an RCT-based modelling study.European heart journal. Digital health · 2025Article
- Challenges and Opportunities for Atrial Fibrillation Management.Cardiology discovery · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
aimsPrevious studies on the cost-effectiveness of screening for atrial fibrillation (AF) are based on assumptions of long-term clinical effects. The STROKESTOP study, which randomised 27 975 persons aged 75/76 years into a screening invitation group and a control group, has a median follow-up time of 6.9 years. The aim of this study was to estimate the cost-effectiveness of population-based screening for AF using clinical outcomes. METHODS AND
resultsThe analysis is based on a Markov cohort model. The prevalence of AF, the use of oral anticoagulation, clinical event data, and all-cause mortality were taken from the STROKESTOP study. The cost for clinical events, age-specific utilities, utility decrement due to stroke, and stroke death was taken from the literature. Uncertainty in the model was considered in a probabilistic sensitivity analysis. Per 1000 individuals invited to the screening, there were 77 gained life years and 65 gained quality-adjusted life years. The incremental cost was €1.77 million lower in the screening invitation group. Gained quality-adjusted life years to a lower cost means that the screening strategy was dominant. The result from 10 000 Monte Carlo simulations showed that the AF screening strategy was cost-effective in 99.2% and cost-saving in 92.7% of the simulations. In the base-case scenario, screening of 1000 individuals resulted in 10.6 [95% confidence interval (CI): -22.5 to 1.4] fewer strokes (8.4 ischaemic and 2.2 haemorrhagic strokes), 1.0 (95% CI: -1.9 to 4.1) more cases of systemic embolism, and 2.9 (95% CI: -18.2 to 13.1) fewer bleedings associated with hospitalization.
conclusionBased on the STROKESTOP study, this analysis shows that a broad AF screening strategy in an elderly population is cost-effective. Efforts should be made to increase screening participation.
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