Disclaimer
This information collection is a core HTA, i.e. an extensive analysis of one or more health technologies using all nine domains of the HTA Core Model. The core HTA is intended to be used as an information base for local (e.g. national or regional) HTAs.

Abdominal Aorta Aneurysm Screening

AAA Screening compared to not doing anything in the screening of Abdominal Aorta Aneurysm (AAA) in elderly at moderate risk of developing AAA

(See detailed scope below)

HTA Core Model Application for Screening Technologies 1.0
Core HTA
Published
Tom Jefferson (age.na.s, Italy), Nicola Vicari (age.na.s, Italy), Katrine Bjørnebek Frønsdal (NOKC, Norway)
Claudia Wild, LBI-HTA (Health problem and current use); Daniela Pertl and Sophie Brunner-Ziegler, GÖG (Description and technical characteristics); Iñaki Imaz, ISCIII-AETS (Safety); Katrine Frønsdal and Ingvil Sæterdal, NOKC (Clinical effectiveness), Suvi Mäklin and Taru Haula, THL-FINOHTA (Costs and economic evaluation); Gottfried Endel, HVB (Ethical analysis); Kristi Liiv and Raul Kiivet, UTA (Organisational aspects); Anne Lee, Lotte Groth Jensen and Claus Loevschall, SDU/CAST (Social aspects); Ingrid Wilbacher, HVB (Legal aspects)
Agenzia nationale per i servizi sanitari regionali (age.na.s), Italy
Central Denmark (Denmark), GÖG (Austria), HVB (Austria), ISCIII – AETS (Spain), LBI-HTA (Austria), NOKC (Norway), SDU/CAST (Denmark), THL - FINOHTA (Finland), UTA (Estonia)
4.5.2011 15.16.00
31.1.2013 18.04.00
Jefferson T, Vicari N, Frønsdal K [eds.]. Abdominal Aorta Aneurysm Screening [Core HTA], Agenzia nationale per i servizi sanitari regionali (age.na.s), Italy; 2013. [cited 30 June 2022]. Available from: http://corehta.info/ViewCover.aspx?id=106

Abdominal Aorta Aneurysm Screening

<< Organisational aspectsLegal aspects >>

Social aspects

Authors: Lotte Groth Jensen, Claus Loevschall, Anne Lee

Summary

There is no evidence that participation in abdominal aortic aneurysm (AAA) screening has a substantial effect on quality of life. Among those detected with a small AAA there are experiences of both limitations in daily life and distress as well as worries about an operation. Patient information in relation to AAA is limited, insufficient and difficult to understand. Though the attendance rate for AAA screening is high, there are obstacles to participation among those at higher risk for AAA.

Introduction

Assessment of the social aspects of abdominal aortic aneurysm (AAA) screening is important since the use of the technology involves some activities on behalf of the person being invited for the screening and because the screening programme might have a significant impact on the person who decides to attend. This domain investigates aspects of information and acceptance of participation in the different parts of the screening programme as well as how participants experience it and how it affects their life and quality of life (QoL).

Methodology

Frame

The collection scope is used in this domain.

TechnologyAAA Screening
Description

Population-based systematic abdominal aortic aneurysm (AAA)screening. This includes one single invitation for the whole target population to do one ultrasound scan examination. Purpose of use: Detect abdominal aortic aneurysm in unruptured phase in order to treat those aneurysms with high risk of rupture.

Intended use of the technologyScreening

Screening programme for abdominal aortic aneurysm

Target condition
Abdominal Aorta Aneurysm (AAA)
Target condition description

All men and women aged 64 or more

Target population

Target population sex: Any. Target population age: elderly. Target population group: Possible future health condition.

Target population description

All men and women aged 64 or more

For: All men and women aged 64 or more.

There is some international variance in the prevalence of AAA. In the western countries the prevalence varies between 5 to 10 % for the 65 – 74 years old men.

In Japan the prevalence is 1 % for the same group of men. The prevalence increases with age.

In England the prevalence is 2 % for men aged 50 – 64 year and 12 % for men aged 80 years or older.

In Denmark the prevalence is 4 % for men aged 65 – 69 and 6 % for men aged 70 – 74 years old. The prevalence for women is significant lower than the prevalence for men.

Comparisonnot doing anything
Description

No population-based AAA screening.

This includes incidental detection of AAA without age or sex limitation while performing abdominal ultrasound examinations due to other/unclear clinical indications and various opportunistic AAA-screening practices

Assessment elements

TopicIssue RelevantResearch questions or rationale for irrelevance
H0001Major life areasWhich social areas does the use of the technology influence?yesWhich social areas do the use of Abdominal Aorta Aneurysm Screening influence and how?
H0002Major life areasWho are the important others that may be affected, in addition to the individual using the technology?yesWho are the important others that may be affected, in addition to the individual participating in the Abdominal Aorta Aneurysm Screening Program ?
H0004Major life areasWhat kind of changes may the use of the technology generate in the individual's role in the major life areas?yesWhat kind of changes may participation in Abdominal Aorta Aneurysm Screening generate in the individual's role in the major life areas?
H0003Major life areasWhat kind of support and resources are needed for the patient or citizen as the technology is introduced?yesWhat kind of support and resources are needed for the patients if the programme for Abdominal Aorta Aneurysm Screening is implemented?
H0010Major life areasWhat kind of social support and resources are needed for the providers as the technology is introduced?noThe question is considered of greater relevance for the organizational aspects
H0011Major life areasWhat kinds of reactions and consequences can the introduction of the technology cause at the overall societal level?noAbdominal Aorta Screening includes a large proportion of the population (only gender and age are inclucion criterias) and a condition not considered to imply stigmatisation
H0005IndividualWhat kind of physical and psychological changes does the implementation and use of the technology bring about and what kind of changes do patients or citizens expect?yesWhat kind of physical and psychological changes does the implementation and use of Abdominal Aorta Aneurysm Screening bring about, and what kind of changes do patients expect?
H0006IndividualHow do patients, citizens and the important others using the technology react and act upon the technology?yesHow does participating in Abdominal Aorta Aneurysm Screening, and their important others, react and act upon the result of the screening?
H0012IndividualAre there factors that could prevent a group or persons to participate?yesAre there factors that could prevent a group or person to participate in the program?
H0007CommunicationWhat is the knowledge and understanding of the technology in patients and citizens?yesWhat is the knowledge and understanding of Abdominal Aorta Aneurysm Screening among patients?
H0008CommunicationHow do patients and citizens perceive the information they receive or require about the technology?yesHow do patients perceive the information they receive or require about Abdominal Aorta Aneurysm Screening?
H0013CommunicationWhat are the social obstacles or prospects in the communication about the technology?yesWhat are the social obstacles or prospects in the communication about Abdominal Aorta Aneurysm Screening ?
H0009CommunicationWhat influences patients’ or citizens’ decisions to use the technology?yesWhat influence patients’ decisions to participate in the Abdominal Aorta Aneurysm Screening Program?

Methodology description

Domain frame

The project scope is applied in this domain. This is supplemented by an understanding of the technology as a programme: the patient is invited for scanning and depending on the outcome eventually for some further actions e.g. watchful waiting (observation by regular scanning), or elective AAA repair (operation either by open aneurysm repair (OAR) or endovascular aneurysm repair (EVAR). Further information on the programme is provided by the organisational domain (see result card RC-ORG1).

Information sources

The literature search

A domain-specific literature search was conducted in October/November 2011. The search was conducted in the following databases: PsychInfo, Cinahl, EMBASE, Cochrane, PubMed, Sociological Abstract, PsycArticles, DARE (Database of Abstract of Reviews of Effect), NHS EED (NHS Economic Evaluation Database) and HTA database CDR (Centre of Reviews and Dissemination). The search resulted in 589 titles after excluding duplicates.

The search was conducted using both thesaurus and free text terms. The main search terms were: abdominal aortic aneurysm, aortic aneurysm, abdominal, AAA, quality of life, codes of ethics, anxiety, false positive reactions, false negative reactions, patient rights and adaptation psychological.

The specific combination of search terms and search strategy is available at {SOC-1}.

Selection of the literature

Selection of literature was done according to criteria for relevance (see also Inclusion criteria and Exclusion criteria below) and by using quality validated checklists.

Inclusion criteria

Study design: No preferences

Population: Men and women from age 64

Intervention: Population screening for AAA

Comparison: No systematic screening for AAA

Outcomes: Quality of life, social impact, information guidelines and psychological effect

Exclusion criteria

The only limitations on the search were language and time of publication. The search included articles publicised from 1995 to 2011, which were in English, German or Scandinavian languages.

Procedure for literature selection

Titles and abstracts resulting from the literature searches were independently assessed by two investigators. Articles were included if considered relevant by one of the investigators resulting in a gross list of 102 publications. The gross list was then further scanned by each of the three investigators transferring articles chosen by two out of three and resulting in a net list of 88 publications.

Articles considered as meeting the inclusion criteria were examined in full text and assessed by two of the three investigators based on the inclusion criteria and quality requirements (see Quality assessment tools and criteria below). Discrepancies were resolved through discussion.

Quality assessment tools or criteria

Each of the 88 studies in the net list was read and evaluated (relevance and internal/external validity) by two of three assessors. A table of studies included was completed by agreement describing each study. For the evaluation different checklists were used depending on the design and methods of the specific study: The Danish National Board of Health provides five checklists from the Danish Secretariat of Clinical Guidelines (DSCG) based on internationally recognised tools and with explanatory notes. Available in Danish only at: http://www.sst.dk/upload/checkliste.doc

An additional and specific search for studies on Patient Participation was conducted in May 2012 identifying further two publications, see appendix {SOC-1}.

 106.Figure1

Figure 1: Flow chart showing the selection of relevant studies

Analysis and synthesis

Descriptive analysis was done. Responsibility for the assessment of the included issues was divided between the three participants, each issue and research question being answered by cooperation between two participants.

Result cards

Major life areas

Result card for SOC1: "Which social areas do the use of Abdominal Aorta Aneurysm Screening influence and how?"

View full card
SOC1: Which social areas do the use of Abdominal Aorta Aneurysm Screening influence and how?
Result

Importance: Important

Transferability: Completely

Result card for SOC2: "Who are the important others that may be affected, in addition to the individual participating in the Abdominal Aorta Aneurysm Screening Program ?"

View full card
SOC2: Who are the important others that may be affected, in addition to the individual participating in the Abdominal Aorta Aneurysm Screening Program ?
Result

Importance: Important

Transferability: Completely

Result card for SOC3: "What kind of changes may participation in Abdominal Aorta Aneurysm Screening generate in the individual&#39;s role in the major life areas?"

View full card
SOC3: What kind of changes may participation in Abdominal Aorta Aneurysm Screening generate in the individual&#39;s role in the major life areas?
Result
Comment

Importance: Important

Transferability: Partially

Result card for SOC12: "What kind of support and resources are needed for the patients if the programme for Abdominal Aorta Aneurysm Screening is implemented?"

View full card
SOC12: What kind of support and resources are needed for the patients if the programme for Abdominal Aorta Aneurysm Screening is implemented?
Result
Comment

Importance: Important

Transferability: Partially

Individual

Result card for SOC4: "What kind of physical and psychological changes does the implementation and use of Abdominal Aorta Aneurysm Screening bring about, and what kind of changes do patients expect?"

View full card
SOC4: What kind of physical and psychological changes does the implementation and use of Abdominal Aorta Aneurysm Screening bring about, and what kind of changes do patients expect?
Result

Importance: Critical

Transferability: Completely

Result card for SOC5: "How does participating in Abdominal Aorta Aneurysm Screening, and their important others, react and act upon the result of the screening?"

View full card
SOC5: How does participating in Abdominal Aorta Aneurysm Screening, and their important others, react and act upon the result of the screening?
Result
Comment

Importance: Critical

Transferability: Completely

Result card for SOC11: "Are there factors that could prevent a group or person to participate in the program?"

View full card
SOC11: Are there factors that could prevent a group or person to participate in the program?
Result

Importance: Important

Transferability: Partially

Communication

Result card for SOC6: "What is the knowledge and understanding of Abdominal Aorta Aneurysm Screening among patients?"

View full card
SOC6: What is the knowledge and understanding of Abdominal Aorta Aneurysm Screening among patients?
Result
Comment

Importance: Optional

Transferability: Partially

Result card for SOC7: "How do patients perceive the information they receive or require about Abdominal Aorta Aneurysm Screening?"

View full card
SOC7: How do patients perceive the information they receive or require about Abdominal Aorta Aneurysm Screening?
Result
Comment

Importance: Critical

Transferability: Partially

Result card for SOC10: "What are the social obstacles or prospects in the communication about Abdominal Aorta Aneurysm Screening ?"

View full card
SOC10: What are the social obstacles or prospects in the communication about Abdominal Aorta Aneurysm Screening ?
Result
Comment

Importance: Important

Transferability: Partially

Result card for SOC8: "What influence patients’ decisions to participate in the Abdominal Aorta Aneurysm Screening Program?"

View full card
SOC8: What influence patients’ decisions to participate in the Abdominal Aorta Aneurysm Screening Program?
Result

Importance: Critical

Transferability: Partially

Discussion

Overall, it is not possible to determine with certainty whether screening for AAA affects the health- related QoL of participants. The optimal design for measuring changes in QoL among screening participants is to compare the participants with a control group that does not take part in screening. Such a comparison should be performed in the time period during which screening takes places. Such a study design has not been identified.

Based on studies in which the participants' QoL was assessed primarily by comparing the participants’ QoL before and after screening, or by comparing the relevant patients with other groups of patients also participating in screening it should be emphasised that participation in AAA screening does not seem to have any substantial effect on QoL.

Most changes in QoL are registered within the relatively large group of participants who are diagnosed with a small AAA. However, the changes in QoL are still limited. The available treatment option for this group of patients comprises participation in a process that includes regular follow-up. Depending on the size and growth rate of the aneurysm, the patients will participate in the monitoring process until the aneurysm requires surgery or until the patient dies of other causes.

Qualitative research points to experiences of distress after being diagnosed with an AAA and feelings of disillusionment when the AAA is growing, as well as worries about an eventual operation. It is possible that the qualitative studies capture some of the psychological effects of screening for AAA, which are not captured in the generic measurements of QoL. Extra attention and support may be needed for the participants offered regular follow-up after an initial AAA screening.

The attendance rate for AAA screening is considered as generally high though there seems to be obstacles for participation (older age, men living alone, men in lower social groups and long travel distance).

Thorough information should be provided to the individual patient  before and after screening as well as in connection with follow-up and the decision about the operation. Nevertheless, studies show patient information in relation to AAA to be limited, insufficient and difficult to understand. Patients differ in relation to how much information they desire and how they best understand information on an asymptomatic condition with uncertain outcomes and distinct risk profiles. Particular attention may be needed for the oldest people among the attendees and for those with little desire for involvement. There is a need to develop guidelines describing how best to provide an initial invitation, optimal risk-benefit information and how to undertake shared decision making for individuals offered AAA screening

In general there is limited evidence showing how patients are affected by AAA screening, how they experience and handle participation in the programme and how best to inform them and support their decisions, which may be initiated by their participation in screening.

References

1. Berterö, Carlsson P, Lundgren F. Screening for abdominal aortic aneurysm, a one-year follow up: An interview study. Journal of Vascular Nursing. 2010;28(3):97-101.

2. Letterstal A, Eldh AC, Olofsson P, Forsberg C. Patients experience of open repair of abdominal aortic aneurysm--Preoperative information, hospital care and recovery. Journal of Clinical Nursing. 2010;19(21-22):3112-22.

3. Collin J. The Oxford Screening Program for aortic aneurysm and screening first-order male siblings of probands with abdominal aortic aneurysm. Ann N YAcad Sci. 1996;800:36-43.

4. Khaira HS, Herbert LM, Crowson MC. Screening for abdominal aortic aneurysms does not increase psychological morbidity. Ann RColl Surg Engl. 1998;80(5):341-2.

5. Wanhainen A, Rosen C, Rutegard J, Bergqvist D, Bjorck M. Low quality of life prior to screening for abdominal aortic aneurysm: a possible risk factor for negative mental effects. Ann Vasc Surg. 2004;18(3):287-93.

6. Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA, et al. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet. 2002;360(9345):1531-9.

7. Lindholt JS, Vammen S, Fasting H, Henneberg EW. Psychological consequences of screening for abdominal aortic aneurysm and conservative treatment of small abdominal aortic aneurysms. EurJ Vasc Endovasc Surg. 2000;20(1):79-83.

8. Lucarotti ME, Heather BP, Shaw E, Poskitt KR. Psychological morbidity associated with abdominal aortic aneurysm screening. EurJ Vasc Endovasc Surg. 1997;14(6):499-501.

9. Spencer CA, Norman PE, Jamrozik K, Tuohy R, Lawrence-Brown M. Is screening for abdominal aortic aneurysm bad for your health and well-being? ANZ J Surg. 2004;74(12):1069-75.

10. Korhonen SJ, Kantonen I, Pettila V, Keranen J, Salo JA, Lepantalo M. Long-term survival and health-related quality of life of patients with ruptured abdominal aortic aneurysm. EurJ Vasc Endovasc Surg. 2003;25(4):350-3.

11. Hennessy A, Barry MC, McGee H, O'Boyle C, Hayes DB, Grace PA. Quality of life following repair of ruptured and elective abdominal aortic aneurysms. EurJ Surg. 1998;164(9):673-7.

12. Hinterseher I, Saeger HD, Koch R, Bloomenthal A, Ockert D, Bergert H. Quality of life and long-term results after ruptured abdominal aortic aneurysm. EurJ Vasc Endovasc Surg. 2004;28(3):262-9.

13. Joseph AY, Fisher JB, Toedter LJ, Balshi JD, Granson MA, Meir-Levi D. Ruptured abdominal aortic aneurysm and quality of life. Vasc Endovascular Surg. 2002;36(1):65-70.

14. Laukontaus SJ, Pettila V, Kantonen I, Salo JA, Ohinmaa A, Lepantalo M. Utility of surgery for ruptured abdominal aortic aneurysm. Ann Vasc Surg. 2006;20(1):42-8.

15. Hill AB, Palerme LP, Brandys T, Lewis R, Steinmetz OK. Health-related quality of life in survivors of open ruptured abdominal aortic aneurysm repair: a matched, controlled cohort study. J Vasc Surg. 2007;46(2):223-9.

16. Tambyraja AL, Fraser SC, Murie JA, Chalmers RT. Functional outcome after open repair of ruptured abdominal aortic aneurysm. J Vasc Surg. 2005;41(5):758-61.

17. Eskandari MK, Bowle SA, Webster MW, Steed DL, Makaroun MS, Muluk SC, et al. Ruptured abdominal aortic aneurysms in the 1990s: Resource utilization, long-term survival, and quality of life after repair. Vascular Surgery. 1998;32(5):415-424.

18. Tambyraja AL, Fraser SC, Murie JA, Chalmers RT. Quality of life after repair of ruptured abdominal aortic aneurysm. European Journal of Vascular and Endovascular Surgery. 2004;28:229-33.

19. Kurz M, Meier T, Pfammatter T, mann-Vesti BR. Quality of life survey after endovascular abdominal aortic aneurysm repair in octogenarians. Int Angiol. 2010;29(3):249-54.

20. De Rango P, Verzini F, Parlani G, Cieri E, Romano L, Loschi D, et al. Quality of life in patients with small abdominal aortic aneurysm: the effect of early endovascular repair versus surveillance in the CAESAR trial. EurJ Vasc Endovasc Surg. 2011;41(3):324-31.

21. Sandstrom V, Bjorvell H, Olofsson P. Functional status and well-being in a group of patients with abdominal aortic aneurysm. Scandinavian Journal of Caring Sciences. 1996;10(3):186-91.

22. Lederle FA, Johnson GR, Wilson SE, Acher CW, Ballard DJ, Littooy FN, et al. Quality of life, impotence, and activity level in a randomized trial of immediate repair versus surveillance of small abdominal aortic aneurysm. J Vasc Surg. 2003;38(4):745-52.

23. Health service costs and quality of life for early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. UK Small Aneurysm Trial Participants. Lancet. 1998;352(21):1656-60.

24. Pettersson M, Bergbom I. The drama of being diagnosed with an aortic aneurysm and undergoing surgery for two different procedures: open repair and endovascular techniques. J Vasc Nurs. 2010;28(1):2-10.

25. Langenberg D, Abholz HH. How do patients cope with controllable abdominal aneurysm?. [German]. Zeitschrift fur Allgemeinmedizin. 2003;79:32-35.

26. Brannstrom M, Bjorck M, Strandberg G, Wanhainen A. Patients' experiences of being informed about having an abdominal aortic aneurysm - a follow-up case study five years after screening. J Vasc Nurs. 2009;27(3):70-4.

27. Berman L, Curry L, Gusberg R, Dardik A, Fraenkel L. Informed consent for abdominal aortic aneurysm repair: The patient's perspective. J Vasc Surg. 2008;48(2):296-302.

28. Berman L, Dardik A, Bradley EH, Gusberg RJ, Fraenkel L. Informed consent for abdominal aortic aneurysm repair: assessing variations in surgeon opinion through a national survey. J Vasc Surg. 2008;47(2):287-95.

29. Letterstal A, Sandstrom V, Olofsson P, Forsberg C. Postoperative mobilization of patients with abdominal aortic aneurysm. Journal of Advanced Nursing. 2004;48(6):560-8.

30. Timmermans D, Molewijk B, Stiggelbout A, Kievit J. Different formats for communicating surgical risks to patients and the effect on choice of treatment. Patienteducationand counseling. 2004;54:255-63.

31. Knops AM, Ubbink DT, Legemate DA, de Haes JC, Goossens A. Information communicated with patients in decision making about their abdominal aortic aneurysm. EurJ Vasc Endovasc Surg. 2010;39(6):708-13.

32. Stiggelbout AM, Molewijk AC, Otten W, van Bockel JH, Bruijninckx CM, Van dSI, et al. The impact of individualized evidence-based decision support on aneurysm patients' decision making, ideals of autonomy, and quality of life. Med Decis Making. 2008;28(5):751-62.

33. Berman L, Curry L, Goldberg C, Gusberg R, Fraenkel L. Pilot testing of a decision support tool for patients with abdominal aortic aneurysms. Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 2011;53(2):285-92.

34. Chaikof EL BD, Dalmon RL, Makuroun MS, Illig KA, Sicard GA, et al. SVS practice guidelines for the care of patients with an abdominal aortic aneurysm: Executive summary. Journal of Vascular Surgery. 2009;50(85).

35. Lindholt JS, Juul S, Henneberg EW, Fasting H. Is screening for abdominal aortic aneurysm acceptable to the population? Selection and recruitment to hospital-based mass screening for abdominal aortic aneurysm. Journal of public health medicine. 1998;20:211-7.

36. Armstrong PA, Back MR, Bandyk DF, Lopez AS, Cannon SK, Johnson BL, et al. Optimizing compliance, efficiency, and safety during surveillance of small abdominal aneurysms. Journal of Vascular Surgery. 2007;46(2):190-6.

Appendices

Appendix SOC-1 Search history for the social domain on AAA screening

PsychInfo: Search history, conducted October 31st, 2011

Search number

Searches

Result

1

("Abdominal aortic aneurysm" or "aortic aneurysm, abdominal" or AAA).mp. [mp=title, abstract, heading word, table of contents, key concepts, original title, tests & measures]

161

2

limit 1 to (peer reviewed journal and human and (360 middle age <age 40 to 64 yrs> or "380 aged <age 65 yrs and older>") and (Danish or English or German or Norwegian or Swedish) and human and yr="1995 - 2011")

34

Cinahl: Search history, conducted October 31st, 2011 and May 2012 (search number 3)

Search number

Searches

Result

1

"Aortic Aneurysm, Abdominal (Thesaurus)

1151

2

"Aortic Aneurysm, Abdominal Published Date from: 19950101-20111031; Peer Reviewed; Human; Language: Danish, English, German, Norwegian, Swedish; Age Groups: Middle Aged: 45-64 years, Aged: 65+ years

257

3

Aortic Aneurysm, Abdominal (Thesaurus) and participation

8

EMBASE: Search history, conducted October 31st, 2011

Search number

Searches

Result

1

abdominal aorta aneurysm (Thesaurus)

15266

2

("Abdominal aortic aneurysm" or "aortic aneurysm, abdominal" or AAA).mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword]

13963

3

1 or 2

20355

4

quality of life (Thesaurus)

176695

5

life satisfaction (Thesaurus)

4763

6

ethics or medical ethics (Thesaurus)

124214

7

anxiety (Thesaurus)

87147

8

false positive result (Thesaurus)

7686

9

false negative result (Thesaurus)

4563

10

patient information (Thesaurus)

15799

11

Information (Thesaurus)

10237

12

patient right (Thesaurus)

10282

13

coping behaviour (Thesaurus)

26229

14

psychological well being (Thesaurus)

3480

15

4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14

442767

16

3 and 15

316

17

limit 16 to (human and (Danish or English or German or Norwegian or Swedish) and yr="1995 - 2011" and (adult <18 to 64 years> or aged <65+ years>))

123

Cochrane: Search history, conducted October 31st, 2011

Search number

Searches

Result

1

Aortic Aneurysm, Abdominal (Thesaurus)

503

2

"abdominal aortic aneurysm" OR "aortic aneurysm, abdimonal" OR AAA

615

3

(#1 OR #2)

748

4

Quality of Life (Thesaurus)

11312

5

Ethics (Thesaurus)

431

6

False Positive Reactions (Thesaurus)

444

7

False Negative Reactions (Thesaurus)

297

8

Adaptation, Psychological (Thesaurus)

3126

9

Anxiety (Thesaurus)

4273

10

(#4 OR #5 OR #6 OR #7 OR #8 OR #9)

18778

11

"patient information" OR information

48632

12

(#10 OR #11)

64991

13

(#3 AND #12), from 1995 to 2011

175

PubMed: Search history, conducted October 31st, 2011 and May 2012 (search number 6)

Search number

Searches

Result

1

Aortic Aneurysm, Abdominal (Thesaurus)

11379

2

“abdominal aortic aneurysm" OR "aortic aneurysm, abdominal" OR AAA

17611

3

(#2) OR #3

17611

4

Quality of Life OR Codes of Ethics OR Anxiety OR False Positive Reactions OR False Negative Reactions OR Patient Rights OR Adaptation, Psychological (Thesaurus)

308158

5

(#4) AND #13 Limits: Humans, English, German, Danish, Norwegian, Swedish, Middle Aged: 45-64 years, Aged: 65+ years, Publication Date from 1995/01/01 to 2011/10/31

113

6

Aortic Aneurysm, Abdominal (Thesaurus) and participation

23

NHS EED, DARE and HTA CDR: Search history, conducted November 2nd, 2011

Search number

Searches

Result

1

Aortic Aneurysm, Abdominal (Thesaurus)

154

2

Quality of Life (Thesaurus)

1440

3

Codes of Ethics (Thesaurus)

0

4

Anxiety (Thesaurus)

134

5

False Positive Reactions (Thesaurus)

95

6

False Negative Reactions (Thesaurus)

51

7

Patient Rights (Thesaurus)

38

8

#2 OR #3 OR #4 OR #5 OR #6 OR #7

1697

9

#1 AND #8

7

Sociological Abstract: Search history, conducted October 31st, 2011

Search number

Searches

Result

1

"abdominal aortic aneurysm" OR "aortic aneurysm, abdominal"

6

Psych articles: Search history, conducted September 28th, 2011

Search number

Searches

Result

1

(("Cancer Screening" OR "Genetic Testing" OR "Health Screening" OR "HIV Testing" OR "Physical Examination") ) OR ("population screening" OR "mass screening")) OR (("opportunistic screening" OR "opportunistic detection"))

Limits: Journal, Peer Reviewed Journal, Journal Article, Review-book; Middle Age (40-64 Yrs), Aged (65 Yrs & Older)

55


<< Organisational aspectsLegal aspects >>