Fifteen-year follow-up of a randomized clinical trial of ultrasonographic screening for abdominal aortic aneurysms

Ashton, H. A.; Gao, Lu; Kim, Lois; Druce, P. S.; Thompson, Simon G.; Scott, R. A. P.

doi:10.1002/bjs.5780

Cited by 182 publications

(108 citation statements)

References 14 publications

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“…Although smokers and non-diabetics have higher rates of growth (see Predictors of abdominal aortic aneurysm growth rates), these factors did not explain the heterogeneity between studies: adjusting for baseline AAA diameter, smoking and diabetes only reduced the overall percentage of variation due to heterogeneity from 97.5% to 94.1%. Excluding the three studies (Chichester, 53 Gloucestershire 37 and MASS 10 ) that measured internal diameters, the pooled mean growth rates decreased by between 0.10 mm/year and 0.13 mm/year, depending on baseline diameter, but the percentage of variation due to heterogeneity only decreased by between 1.5% and 3.3%. …”

Section: Small Abdominal Aortic Aneurysm Growth Rates In Menmentioning

confidence: 95%

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Thompson

Brown²,

Sweeting³

et al. 2013

Health Technology Assessment

186

177

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This report should be referenced as follows:Thompson SG, Brown LC, Sweeting MJ, Bown MJ, Kim LG, Glover MJ, et al. Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness. Health Technol Assess 2013;17(41). Health Technology Assessment is indexed in MEDLINE, CINAHL, EMBASE, The Cochrane Library and the ISI Science Citation Index and is assessed for inclusion in the Database of Abstracts of Reviews of Effects. Health Technology Assessment is indexed and abstracted inThis journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/30/02. The contractual start date was in November 2009. The draft report began editorial review in July 2012 and was accepted for publication in November 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research...

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Section: Small Abdominal Aortic Aneurysm Growth Rates In Menmentioning

confidence: 95%

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Thompson

Brown²,

Sweeting³

et al. 2013

Health Technology Assessment

186

177

View full text Add to dashboard Cite

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“…It was also unique as it included women as well as men. It identified all men and women aged between 65 and 80 years of age from 9 general practices in the catchment area of St Richard's hospital in Chichester between 1988 and 1991 2,8,9 . The subjects were randomised to undergo a single screening ultrasound (US) or a control group who were followed up.…”

Section: Targeted Screening For Aaamentioning

confidence: 99%

The Evidence for Management of Abdominal Aortic Aneurysms: Lessons Learned from Randomised Controlled Trials

Mofidi¹,

Suttie²

2011

Aneurysmal Disease of the Thoracic and Abdominal Aorta

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“…This had been expected given the relative infrequency of AAA as a cause of death. Meanwhile the final results of the Chichester study have been reported (Ashton et al, 2007) with respect to 6040 men randomized to ultrasound screening or to the control group. Screening detected an AAA in 170 patients.…”

Section: Screening For Aaamentioning

confidence: 99%

The Abdominal Aortic Aneurysm – Prognosis, Treatment, Screening and Cost-Effectiveness

Grundmann¹

2011

Diagnosis, Screening and Treatment of Abdominal, Thoracoabdominal and Thoracic Aortic Aneurysms

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Prevalence of abdominal aortic aneurysm and mortality rateGenerally, an AAA is considered to be present when the minimum anterioposterior diameter of the aorta reaches 3.0 cm (Hirsch et al., 2006). The prevalence of AAA depends on various risk factors, as advancing age, family history, male gender, and tobacco use. According to the ACC/AHA guidelines (Hirsch et al., 2006) the prevalence of AAA 2.9 to 4.9 cm in diameter ranges from 1.3 % for men aged 45 to 54 years up to 12.5 % for men 75 to 84 years of age. Comparable prevalence figures for women are 0% and 5.2 %, respectively. Scott et al., 1995 reported in men and women aged 65-80 years a prevalence rate of 4 % overall and 7.6 % of men. Vardulaki et al., 1999 observed in two different areas the prevalence of AAA ranging between 5.3 % and 8% and between 6.18% and 9.88 %, respectively, in men aged between 65 and 79 years. In the Multicentre Aneurysm Screening Study (MASS) the prevalence in men aged 65-74 years was 4.9% (Ashton et al., 2002). In these studies the AAA was defined as an aortic diameter  3cm. If clinically important aneurysms are only taken into account (AAA www.intechopen.com Diagnosis, Screening and Treatment of Abdominal, Thoracoabdominal and Thoracic Aortic Aneurysms 2 measuring  4 cm in diameter) the indicated prevalence would be lower. Van Walraven et al., 2010 identified the prevalence of incidental AAA during imaging for other reasons. In 79,121 abdominal images 812 incidental AAA with a mean diameter of 4.0 cm (1% of all studies) were detected in patients with a mean age of 74 years. Lederle et al., 1997 reported the results of ultrasonography screening for AAA in 73,451 US veterans who were 50 to 79 years of age and had no history of AAA. The infrarenal aortic diameter was at least 4 cm in 1031 patients (1.4%), 368 patients (0.5%) had an AAA of 5 cm or larger. Smoking was the factor most closely associated with AAA in this study. In men who never smoked the prevalence of AAA 4 cm or larger was 0 % (patient age 50 to 59 years) and 0.8% (patient age > 75 years), respectively. The corresponding figures for men who smoked were 0.9 % and 2.7 %, respectively. A second cohort study of the Department of Veterans Affairs medical centers (Lederle et al., 2000) including 52,745 subjects aged 50 to 79 years confirmed the findings previously reported and supported the hypothesis that AAA is primarily a smoking-related disease. In this study AAA of 4.0 cm or larger were detected in 613 participants (1.2%). The excess prevalence associated with smoking accounted for approximately 75% of all AAA of 4.0 cm or larger. Smoking as a very strong risk factor for AAA was also proven by the Tromsø study (Forsdahl et al., 2009). When subjects who reported to have never been a daily smoker were compared with those who currently were smoking 20 cigarettes or more, the latter group had a > 13 times increased risk of an incident AAA during follow-up. In the women`s health initiative, an observational study involving 161,808 postmenopausal women, too, a strong positi...

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Fifteen-year follow-up of a randomized clinical trial of ultrasonographic screening for abdominal aortic aneurysms

Cited by 182 publications

References 14 publications

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness

The Evidence for Management of Abdominal Aortic Aneurysms: Lessons Learned from Randomised Controlled Trials

The Abdominal Aortic Aneurysm – Prognosis, Treatment, Screening and Cost-Effectiveness

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