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Cost-Effectiveness of Preparticipation Screening for Prevention of Sudden Cardiac Death in Young Athletes

机译:参与筛查预防年轻运动员心源性猝死的成本效益

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Background: Inclusion of 12-lead electrocardiography (ECG) in preparticipation screening of young athletes is controversial because of concerns about cost-effectiveness. nnObjective: To evaluate the cost-effectiveness of ECG plus cardiovascular-focused history and physical examination compared with cardiovascular-focused history and physical examination alone for preparticipation screening. nnDesign: Decision-analysis, cost-effectiveness model. nnData Sources: Published epidemiologic and preparticipation screening data, vital statistics, and other publicly available data. nnTarget Population: Competitive athletes in high school and college aged 14 to 22 years. nnTime Horizon: Lifetime. nnPerspective: Societal. nnIntervention: Nonparticipation in competitive athletic activity and disease-specific treatment for identified athletes with heart disease. nnOutcome Measure: Incremental health care cost per life-year gained. nnResults of Base-Case Analysis: Addition of ECG to preparticipation screening saves 2.06 life-years per 1000 athletes at an incremental total cost of $89 per athlete and yields a cost-effectiveness ratio of $42 900 per life-year saved (95% CI, $21 200 to $71 300 per life-year saved) compared with cardiovascular-focused history and physical examination alone. Compared with no screening, ECG plus cardiovascular-focused history and physical examination saves 2.6 life-years per 1000 athletes screened and costs $199 per athlete, yielding a cost-effectiveness ratio of $76 100 per life-year saved ($62 400 to $130 000). nnResults of Sensitivity Analysis: Results are sensitive to the relative risk reduction associated with nonparticipation and the cost of initial screening. nnLimitations: Effectiveness data are derived from 1 major European study. Patterns of causes of sudden death may vary among countries. nnConclusion: Screening young athletes with 12-lead ECG plus cardiovascular-focused history and physical examination may be cost-effective. nnPrimary Funding Source: Stanford Cardiovascular Institute and the Breetwor Foundation.
机译:背景:由于对成本效益的担忧,在年轻运动员的参与前筛查中包括12导联心电图(ECG)是有争议的。 nn目的:与参与检查的单独以心血管病史和体格检查相比,评估ECG加上心血管病史和体格检查的成本效益。 nnDesign:决策分析,成本效益模型。 nn数据来源:已发布的流行病学和参与前筛查数据,生命统计数据以及其他可公开获得的数据。目标人群:高中和大学中14至22岁的竞技运动员。 nnTime Horizo​​n:生命周期。 nnPerspective:社会。 nn干预:不参与竞技体育活动和已识别出心脏病的运动员的疾病特定治疗。 nn成果衡量:获得的每生命年增量医疗费用。 nn基本案例分析的结果:在参与前的筛查中加上ECG,每1000名运动员可节省2.06个生命年,每名运动员的总成本为89美元,而成本效益比为每个生命年节省42900美元(95%CI,相对于以心血管疾病为主的病史和体格检查,每生命年可节省21200至71300美元。与不进行筛查相比,心电图加上以心血管为中心的病史和体格检查每1000名被筛查运动员可节省2.6个生命年,每名运动员花费199美元,每生命年节省的成本效益比为76100美元(62400美元至130000美元) 。 nn敏感性分析的结果:结果对与不参与相关的相对风险降低以及初始筛查的成本敏感。 nnLimitations:有效性数据来自1项主要的欧洲研究。各国之间猝死的原因模式可能有所不同。结论:筛查具有12导联心电图以及以心血管为中心的病史和体格检查的年轻运动员可能具有成本效益。 nn原始资金来源:斯坦福心血管研究所和Breetwor基金会。

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