{"id":"91f230e06b78","type":"article","url":"https://hartvaat.nl/2023/01/14/strokestop-af-screening-is-kosteneffectief-bij-75-76-jarigen/","title":"STROKESTOP: AF-screening is kosteneffectief bij 75-76-jarigen","title_en":"Cost-effectiveness of population screening for atrial fibrillation: the STROKESTOP study.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog","huisarts"],"tags":["primaire-preventie"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehac547","source_url":"https://doi.org/10.1093/eurheartj/ehac547","authors":["Johan Lyth","Emma Svennberg","Lars Bernfort","Mattias Aronsson","Viveka Frykman","Faris Al-Khalili","Leif Friberg","Mårten Rosenqvist","Johan Engdahl","Lars-Åke Levin"],"significance":8,"published":"2023-01-14","source_date":"2023-01-14","image":"","kennis":[],"congress":"","summary_en":"The STROKESTOP cost-effectiveness analysis showed that population-level screening for atrial fibrillation in 75-76-year-olds using intermittent ECG recordings is cost-effective, with favorable incremental cost per QALY gained. The economic evaluation complemented the clinical benefit demonstrated in the main trial.","created":"2026-07-03T10:30:11Z","updated":"2026-07-03T13:29:15Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De STROKESTOP-studie toonde dat populatiescreening voor AF bij 75-76-jarigen kosteneffectief was met een gunstige incrementele kosten-per-QALY ratio. Dit is het eerste gerandomiseerde bewijs dat AF-screening economisch verantwoord is.","abstract_original":"AIMS: Previous studies on the cost-effectiveness of screening for atrial fibrillation (AF) are based on assumptions of long-term clinical effects. The STROKESTOP study, which randomised 27 975 persons aged 75/76 years into a screening invitation group and a control group, has a median follow-up time of 6.9 years. The aim of this study was to estimate the cost-effectiveness of population-based screening for AF using clinical outcomes. METHODS AND RESULTS: The analysis is based on a Markov cohort model. The prevalence of AF, the use of oral anticoagulation, clinical event data, and all-cause mortality were taken from the STROKESTOP study. The cost for clinical events, age-specific utilities, utility decrement due to stroke, and stroke death was taken from the literature. Uncertainty in the model was considered in a probabilistic sensitivity analysis. Per 1000 individuals invited to the screening, there were 77 gained life years and 65 gained quality-adjusted life years. The incremental cost was €1.77 million lower in the screening invitation group. Gained quality-adjusted life years to a lower cost means that the screening strategy was dominant. The result from 10 000 Monte Carlo simulations showed that the AF screening strategy was cost-effective in 99.2% and cost-saving in 92.7% of the simulations. In the base-case scenario, screening of 1000 individuals resulted in 10.6 [95% confidence interval (CI): -22.5 to 1.4] fewer strokes (8.4 ischaemic and 2.2 haemorrhagic strokes), 1.0 (95% CI: -1.9 to 4.1) more cases of systemic embolism, and 2.9 (95% CI: -18.2 to 13.1) fewer bleedings associated with hospitalization. CONCLUSION: Based on the STROKESTOP study, this analysis shows that a broad AF screening strategy in an elderly population is cost-effective. Efforts should be made to increase screening participation."}