Result card

  • EFF1: What is the effect of Abdominal Aorta Aneurysm Screening on overall mortality?
Abdominal Aorta Aneurysm Screening
D0001
English
Guidance Resources

What is the effect of Abdominal Aorta Aneurysm Screening on overall mortality?

Authors: Katrine Frønsdal, Stefan Sauerland and Ingvil Sæterdal

Internal reviewers: Pseudo164 Pseudo164, Pseudo179 Pseudo179, Pseudo71 Pseudo71, Pseudo98 Pseudo98

Evidence from the basic literature search (done for the whole project) was used to assess this element. Methods for reporting clinical effectiveness data and assessment of strength of evidence are as described in Domain Methodology.

Three SRs were included to assess the effect of AAA screening on the overall or ‘all-cause’ mortality outcomes (Takagi 2010; Lindholt & Norman 2008; Cosford 2007). While the SRs by Takagi et al. and Lindholt & Norman were assessed as being of medium quality, the SR by Cosford et al. was determined to be of high quality (Appendix EFF-2, Section 2). GRADE Summary of findings (SoF) tables for these series of outcomes are shown in Appendix EFF-2 Section 5.

Overall mortality in men (long-term)

The  Takagi et al. SR was the most recent SR assessing long-term (i.e. after 7 to 15 years) overall mortality in men (Takagi 2010). Four RCTs included in total 114,376 men aged 65 years or more randomised to an invitation to attend screening for AAA (n=57,181) or no invitation (control; n=57,195). Pooled analysis of the four odds ratios (ORs) showed a non-significant reduction in overall mortality in the screened group (see SoF table in Appendix EFF-2 Section 5). The fixed-effect OR was 0.98 with a 95% confidence interval (CI) of 0.95 to 1.00, P=0.06.

Overall mortality in men (medium term)

The Lindholt & Norman SR was the most recent SR assessing medium term (i.e. after 3½ to 5 years) overall mortality in men (Lindholt & Norman 2008). Four RCTs included in total 125,576 men aged between 64 and 83 years randomised to an invitation to attend screening for AAA (n=62,729) or no invitation (control; n=62,847). Pooled analysis of the four ORs showed a non-significant reduction in overall mortality in the screened group (see SoF table in Appendix EFF-2 Section 5). The random-effect OR was 0.94 with a 95% CI of 0.86 to 1.20, P=0.14.

Overall mortality in women

The Cosford et al. SR was the most recent SR assessing overall mortality in women (Cosford 2007). One RCT included in total 9,342 women aged between 65 and 80 years randomised to an invitation to attend screening for AAA (n=4,682) or no invitation (control; n=4,660). The ORs showed a non-significant increase in overall mortality in the screened group (see SoF table in Appendix EFF-2 Section 5). The random-effect OR was 1.06 with a 95% CI of 0.93 to 1.21, P=0.40.

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Frønsdal K, Sæterdal S Result Card EFF1 In: Frønsdal K, Sæterdal S Clinical Effectiveness In: 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 28 May 2023]. Available from: http://corehta.info/ViewCover.aspx?id=106