In-silico trials of targeted screening for abdominal aortic aneurysms using linked healthcare data: A study protocol

Area of Science:

• Vascular Surgery
• Public Health
• Health Economics

Background:

• The National Health Service (NHS) abdominal aortic aneurysm (AAA) screening programme (NAAASP) is effective but faces declining disease prevalence.
• Decreasing AAA prevalence reduces the efficiency of the current NAAASP policy.
• Targeted screening of high-risk groups is a potential alternative, but its clinical and economic viability is unknown.

Purpose of the Study:

• To estimate the clinical outcomes of targeted AAA screening.
• To assess the cost-effectiveness of targeted AAA screening compared to the current whole-population strategy.

Main Methods:

• In-silico trials using linked NAAASP and Clinical Practice Research Datalink (CPRD) data (approx. 2,500,000 men).
• Development of a risk prediction model to identify high-risk criteria for targeted screening.
• Qualitative evidence synthesis to explore acceptability issues of targeted screening.
• Discrete event simulation to extrapolate findings and estimate cost-effectiveness.

Main Results:

• Diagnostic accuracy of risk prediction models for identifying AAA in silico.
• Comparison of clinical outcomes and cost-effectiveness between targeted and whole-population screening.

Conclusions:

• This research is expected to significantly impact AAA screening policies globally.
• Findings will inform future NHS, UK, and worldwide AAA screening strategies.