In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
Abstract:
Introduction: Screening of atrial fibrillation (AF) using contemporary wrist-worn wearable devices may prevent strokes, but false positive diagnoses could also lead to unnecessary bleeding and utilization of healthcare resources. Aim: To assess the cost-effectiveness of contemporary AF screening strategies and identify optimal conditions for the deployment of such strategies. Methods: We developed a microsimulation model to evaluate 8 distinct AF screening strategies, including 6 strategies utilizing wrist-worn wearable devices and 2 strategies utilizing traditional modalities ( Figure ). Within a simulated cohort of 30 million individuals with an age, sex, and comorbidity profile matching the US population aged ≥65 years (i.e., with a guideline-based screening indication), we assessed cost-effectiveness from the healthcare system perspective using incremental cost-effectiveness ratios (ICERs) at a willingness-to-pay of $100,000 per quality-adjusted life-year (QALY). We used scenario analyses to identify conditions under which the cost-effectiveness of screening may be optimized. Results: In the base case analysis, 7/8 strategies were effective (87.5%, range of QALYs gained 14-862 per 100,000 people). All 6 contemporary screening strategies were effective (range of QALYs gained 226-957 per 100,000 people). The most cost-effective strategy was wearable photoplethysmography, followed conditionally by wearable electrocardiogram with patch monitor confirmation (ICER $57,882/QALY, Figure). The cost-effectiveness of screening was consistent across multiple scenarios, including across strata of sex and targeting the US population aged ≥50 years. Conclusions: AF screening utilizing wrist-worn wearable devices appears cost-effective, and merits prioritization by potential payers.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.144.suppl_1.13373
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
1466401-X
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