■通过遵循指南和回顾先前的影像学检查,评估超声(US)筛查腹主动脉瘤(AAA)的适当性和潜在的成本节省。
■对2019年1月1日至4月30日在新斯科舍省进行的主动脉超声筛查进行了回顾。病人性,年龄,危险因素,和研究结果(阴性,<2.5cm;外生,2.5-2.9厘米;AAA阳性,记录≥3cm)。回顾了先前的影像学检查是否存在主动脉扩张或动脉瘤。适当性基于加拿大预防保健工作组(CTFPHC)和加拿大血管外科学会(CSVS)指南。潜在避开美国的人数,随后错过了积极的发现,和成本节省(在4个月期间)的计算根据:1)每个指南;和2)每个指南结合0~5年和0~10年前的影像学检查.
■369例主动脉中有17例(4.6%),369例主动脉中有18例(4.9%)。可能避免的检查数量,切除主动脉,错过了AAAs,成本节约如下,分别为:CTFPHC,369、8、7和20加元的222(60.2%)501.70美元;CSVS,369、4、2和10804.95加元中的117(31.7%)。将CSVS指南与5年内以前的影像学检查相结合,将产生最大的成本节省和最少的错过积极结果的模型;这将避免369项检查中的189项(51.2%),节省CAD$17454.15超过4个月,仅错过2个AAAs和2个扩张主动脉。
■通过遵守CSVS指南并审查5年内进行的影像学检查,可以安全地避免超过一半的主动脉US筛查测试。
UNASSIGNED: To assess the appropriateness of abdominal aortic aneurysm (AAA) screening with ultrasound (US) and potential cost savings by adhering to
guidelines and reviewing prior imaging.
UNASSIGNED: Screening aortic US performed in Nova Scotia from January 1 to April 30, 2019, were reviewed. Patient sex, age, risk factors, and study result (negative, <2.5 cm; ectatic, 2.5-2.9 cm; positive for AAA, ≥3 cm) were recorded. Previous imaging tests were reviewed for the presence/absence of aortic ectasia or aneurysm. Appropriateness was based on the Canadian Task Force on Preventive Health Care (CTFPHC) and the Canadian Society of Vascular Surgery (CSVS) guidelines. The number of potentially averted US, subsequent missed positive findings, and cost savings (over the 4-month period) were calculated according to: 1) each
guideline; and 2) each
guideline combined with review of imaging done 0 to 5 years and 0 to 10 years previously.
UNASSIGNED: There were 17 (4.6%) of 369 ectatic aortas and 18 (4.9%) of 369 AAAs. The number of potentially averted examinations, missed ectatic aortas, missed AAAs, and cost savings were as follows, respectively: CTFPHC, 222 (60.2%) of 369, 8, 7, and CAD$20 501.70; CSVS, 117 (31.7%) of 369, 4, 2, and CAD$10 804.95. The model that would yield the greatest cost savings and fewest missed positive findings was the combination of CSVS
guidelines with review of prior imaging within 5 years; this would avert 189 (51.2%) of 369 examinations, save CAD$17 454.15 over 4 months, and miss only 2 AAAs and 2 ectatic aortas.
UNASSIGNED: Over half of aortic US screening tests can be safely averted by adhering to CSVS
guidelines and reviewing imaging performed within 5 years.