A detailed model for simulation of AAA development was developed. The main aim of the work was to compare the effectiveness of organized screening to current practice for a 65-year old cohort over 20 years whereas the target figures are ruptures, death cases and costs per life year gained. Most published studies just look at men because of the higher incidence but here the effects on men and women are analyzed.
Chistoph Urach; Guenther Zauner; Ingrid Wilbacher; Gottfried Endel; Florian Miksch; Felix Breitenecker. Abdominal Aorta Aneurysm - Cost-Effectiveness Analysis on Introduction of Organized Screening in Comparison to Current Practice in Austria. http://www.hauptverband.at/portal27/hvbportal/content?contentid=10007.694087&viewmode=content
In this study, a previously defined screening strategy (as proposed by EUnetHTA) was tested and evaluated. The model itself allows answering additional questions, for example “Which is the optimal screening strategy?” Such a question can be investigated considering various outcome measurements (e.g. ruptures, death cases, ICER). It is possible to test screening intervals dependent on diameter size or other included parameters as well as testing interventions for different age groups. Such a detailed analysis can provide valuable information for designing optimal patient-oriented screening strategies and recommendations. Also, giving up the cohort approach and looking at the whole population could provide an overview about annual cases, corresponding hospital stays and costs.
Surgery techniques are steadily improving. Another subject to investigation could be the influence on outcome measures of various assumptions on lower surgery mortality rates or even other interventions (e.g. medication for reduced AAA growth).
In Chapter 6, influence of smoking ‘eradication’ on AAA development as well as ruptures is tested. This scenario, although showing the potential of smoking cessation programs, is not realistic, therefore it makes sense to implement realistic smoking cessation programs and compare these to other interventions.