These US authors evaluated the cost-effectiveness of ECG plus cardiovascular-focused history and physical examination compared with cardiovascular-focused history and physical examination alone for preparticipation screening. They developed a decision-analysis, cost- effectiveness model using published epidemiologic and preparticipation screening data, vital statistics, and other publicly available data.
They found: "Results 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 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. Results of Sensitivity Analysis: Results are sensitive to the relative risk reduction associated with nonparticipation and the cost of initial screening."
The authors concluded: "Screening young athletes with 12-lead ECG plus cardiovascular-focused history and physical examination may be cost- effective."
The published data used to build the model were too limited to draw firm conclusions.
For the full abstract, click here.
Annals of Internal Medicine 152(5):276-286, 2 March 2010 © 2010 to the American College of Physicians
Cost-Effectiveness of Preparticipation Screening for Prevention of Sudden Cardiac Death in Young Athletes. Matthew T. Wheeler, Paul A. Heidenreich, Victor F. Froelicher, Mark A. Hlatky, and Euan A. Ashley. Correspondence to: Dr. Ashley: euan@stanford.edu
Category: K. Circulatory. Keywords: electrocardiogram, ECG, students, athletes, sports, preparticipation screening, cost-effectiveness analysis, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 16 March 2010
