PCV165 - Assessing the Impact of Organized Screening for Abdominal Aorta Aneurysms in Austria – Following Eunethta Core Information

Abstract

Objectives: Abdominal Aorta Aneurysms (AAAs) refers to distension of the abdominal aorta. It is a common disease among 65+ year old people with increasing importance due to overageing of the population. Currently, AAAs in Austria are only incidentally detected and due to its asymptomatic course often overlooked therefore the impact of an organized screening program in Austria was evaluated. Methods: An agent based simulation model for Austria's population was developed. Each agent represents a person which has an individual development of its aorta depending on age, sex, and smoking habits. Identification of risk factors and parameterization of the model was performed in the IFEDH project (FFG grant number 827347). The observed persons are 65 years old at simulation start and the observed time horizon is 20 years. The chosen screening strategy which is compared to current practice corresponds to the EUnetHTA scheme with an assumed 40% participation. Results: Events like ruptures, deaths or treatment are recorded and accumulated over the whole simulation time. Additionally, because many figures of the model depend on probabilities, the point in time when patients benefit from the intervention with 95% probability is calculated. Ruptures are reduced from 786 to 531, death cases from 571 to 433 whereas the costs per life year gained are about 7500 Euro . Significant differences can be observed after about four years. Although incidence is much higher among men, it is remarkable that screening is more cost-effective for women due to higher risk of rupture and life expectancy. Conclusions: The agent based simulation model allows detailed analysis of groups with specific properties, e.g.smokers, other age groups and different screening strategies. It also allows decision makers to estimate when the impact of the intervention, in this case organized screening, can be observed or measured within the real population.