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- Title
Cost-Effectiveness of Preparticipation Screening for Prevention of Sudden Cardiac Death in Young Athletes.
- Authors
Wheeler, Matthew T.; Heidenreich, Paul A.; Froelicher, Victor F.; Hlatky, Mark A.; Ashley, Euan A.
- Abstract
Background: Inclusion of 12-lead electrocardiography (ECG) in preparticipation screening of young athletes is controversial because of concerns about cost-effectiveness. Objective: 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. Design: Decision-analysis, cost-effectiveness model. Data Sources: Published epidemiologic and preparticipation screening data, vital statistics, and other publicly available data. Target Population: Competitive athletes in high school and college aged 14 to 22 years. Time Horizon: Lifetime. Perspective: Societal. Intervention: Nonparticipation in competitive athletic activity and disease-specific treatment for identified athletes with heart disease. Outcome Measure: Incremental health care cost per life-year gained. 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 (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). Results of Sensitivity Analysis: Results are sensitive to the relative risk reduction associated with nonparticipation and the cost of initial screening. Limitations: Effectiveness data are derived from 1 major European study. Patterns of causes of sudden death may vary among countries. Conclusion: Screening young athletes with 12-lead ECG plus cardiovascular-focused history and physical examination may be cost-effective.
- Subjects
UNITED States; ELECTROCARDIOGRAPHY; COLLEGE athletes; PSYCHIATRIC epidemiology; COST effectiveness; ELECTRIC properties of hearts; DIAGNOSTIC imaging; PHYSIOLOGY
- Publication
Annals of Internal Medicine, 2010, Vol 152, Issue 5, p276
- ISSN
0003-4819
- Publication type
Article
- DOI
10.7326/0003-4819-152-5-201003020-00005