Cost-Effectiveness Of Atrial Fibrillation Screening Strategies: A Systematic Review

Abstract

Objective: This study aims to analyze the cost-effectiveness of atrial fibrillation screening strategies.Design: Systematic review Setting: LiteraturePatient(s): Patients with atrial fibrillation.Intervention(s): To find related research and articles in this field, articles published in Iranian and international databases and based on inclusion and exclusion criteria were searched and reviewed. The quality-adjusted life-years (QALYs) were the main outcome used for measuring the effectiveness.­Main Outcome Measure(s): Incremental cost-effectiveness ratios (ICER) per gained or additional QALY, additional case detected, and avoided stroke.Result(s): Out of 3,360 studies found in the field of the present study, finally, fifteen studies were included in the research. The lowest ICER numerical value was 78.39 for AF screening using ECG for 65-85-year-old Japanese women. The highest value of this index is equal to 70864.31 for performing ECG monitoring for more than 60 days for Canadians over 80 years without AF history who have been referred to outpatient clinics. In two studies, the results were expressed with the Years of life gained (YLG) measure. Of course, in one study, the results were not reported with this measure and in one study, the results were reported with ICER. Conclusion(s): According to the results of all the studies analyzed, most of the studies acknowledged the cost-effectiveness of different AF screening strategies. However, studies that confirmed the cost-effectiveness of population-based screening were more than studies that confirmed the cost-effectiveness of other screening strategies.