Outcomes of an abdominal aortic aneurysm screening program

Abstract

A large AAA screening program at the VA detects more aneurysms, but at smaller diameters than that published in clinical trials. Over time, the number of inappropriate AAA screenings has continued to decrease, demonstrating greater awareness and application of the AAA screening guidelines by primary care providers. Developing surveillance guidelines for small and medium aneurysms is a potential area for future research.

Abdominal Aortic Aneurysm Screening Practices: Impact of the 2014 U.S. Preventive Services Task Force Recommendations

“…We cannot directly conclude that the revised USPSTF recommendations caused changes in screening practices. Indeed, past work has shown over time a trend toward greater examination appropriateness and AAA detection rates, as well as decreases in aneurysm size at diagnosis, even in years before the new recommendations [23]. Moreover, the percentage of definitely appropriate examinations peaked in the calendar quarter before the release of the new USPSTF recommendations, making it more difficult to establish a cause-andeffect relationship.…”

Abdominal aortic aneurysm screening in the United States

“…Compare this to 10,000 patients screened nationally through SAAAVE [22]. We reported the 5-year outcomes of the VANCHCS AAA screening program and determined that 9,751 patients were screened within the first 5 years of the program (2007-2011) [9]. There was an aneurysm detection rate of 7.2% (698/9,751 patients) of all screened patients.…”

“…Fig. 2) as described by Chun et al [9]. Furthermore, utilizing the EMR allows for a risk factor analysis of the Veteran AAA screening population in the Northern California region.…”

“…The VANCHCS AAA screening program detected aneurysms in patients who did not initially meet screening age criteria [9]. For instance, 35% (n=244) of all AAA patients were older than 75 years of age compared with 8% (n=55) of all AAA patients who were younger than 65 years of age.…”

“…A maturing population-based screening program will need to deal with a large number of small AAAs (<5.5 cm) that will need to be followed up appropriately. The National Health Service in England utilizes a fulltime coordinator in each health system region [12] and the VANCHCS has a designated study coordinator [9] to help analyze their respective AAA screening programs. Population-based AAA screening programs would benefit from an EMR and a designated, full-time screening coordinator because they would greatly assist clinicians in effectively implementing AAA screening programs and in the follow-up of patients with detected aortic diameters of 2.5-5.4 cm.…”