Individual-level quality-of-life changes are common after aneurysm screening in women: A prospective cohort study

Screening for intracranial aneurysms enables the treatment of lesions at risk of rupture, but concerns remain about its psychological effects. We investigated the impact of screening on health-related quality of life (HRQoL) in 50-60-year-old female smokers.

How does aneurysm screening affect HRQoL?

HRQoL was prospectively assessed using 15D and EQ-5D-3L before, 3 months, and 12 months after screening. Changes in individual HRQoL domains were analyzed, and MIC thresholds were used to define clinically relevant changes in the EQ index and EQ visual analogue scale (EQ VAS). Linear mixed models determined whether the timepoint, computed tomography angiography (CTA) results, or their interaction affected EQ outcomes.

Of 108 women, 13 had abnormal vascular findings, and two underwent surgery. Three-month follow-up questionnaires were returned by 92 participants and 57 completed the 12-month follow-up. Linear mixed models showed no effect of timepoint, CTA results, or their interaction on EQ index or EQ VAS. Nevertheless, 54 participants (59%) deteriorated in at least one 15D domain, including depression (n = 14), sleep (n = 12), and anxiety (n = 9). Sixty-seven reported improvements, notably in sleep (n = 22), symptoms and discomfort (n = 19), and vitality (n = 19). By MIC thresholds, 11 participants showed clinically significant EQ index worsening and nine improvement.

Overall EQ-5D scores suggested no HRQoL impairment, but individual-level analyses revealed worsening of anxiety and depression irrespective of screening results. Standard HRQoL instruments may miss psychosocial effects of screening. Future studies should incorporate pre-invitation baseline assessments and anxiety-specific measures alongside generic HRQoL questionnaires.