Result card

  • EFF2: What is the effect of Abdominal Aorta Aneurysm Screening on the mortality caused by the target disease?
Abdominal Aorta Aneurysm Screening
D0002
English
Guidance Resources

What is the effect of Abdominal Aorta Aneurysm Screening on the mortality caused by the target disease?

Authors: Katrine Frønsdal, Stefan Sauerland and Ingvil Sæterdal

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

Evidence from the literature basic 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 the Domain Methodology.

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

AAA-related 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) AAA-related mortality in men (Takagi 2010). Three RCTs included in total 86,449 men aged 65 years or more randomised to an invitation to attend screening for AAA (n=43,211) or no invitation (control; n=43,238). Pooled analysis of the three ORs showed a significant reduction in AAA-related mortality in the screened group (see SoF table in Appendix EFF-2 Section 5). The random-effect OR was 0.55 with a 95% CI of 0.36 to 0.86, P=0.008.

AAA-related mortality in men (medium term)

The Lindholt & Norman SR was the most recent SR assessing medium term (i.e. after 3½ to 5 years) AAA-related 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 significant reduction in AAA-related mortality (see SoF table in Appendix EFF-2 Section 5). The fixed-effect OR was 0.56 with a 95% CI of 0.44 to 0.72, P<0.00001.

AAA-related mortality in women

The Cosford et al. SR was the most recent systematic review assessing AAA-related 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 OR shows a non-significant increase in AAA-related mortality in the screened group (see SoF table in Appendix EFF-2 Section 5). The random-effect OR is 1.99 with a 95% CI of 0.36 to 10.88, P=0.43.

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Frønsdal K, Sæterdal S Result Card EFF2 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