Evidence suggests that systematic screening and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice .
Although these approaches have comparable effects on the overall AF diagnosis rate , the cost of systematic screening is significantly greater than the cost of opportunistic screening from the perspective of the health service provider .
BACKGROUND Atrial fibrillation ( AF ) , the most common arrhythmia in clinical practice , is a leading cause of morbidity and mortality .
Screening for AF in asymptomatic patients has been proposed as a way of reducing the burden of the disease by detecting people who would benefit from prophylactic anticoagulation therapy before the onset of symptoms .
However , for screening to be an effective intervention , it must improve the detection of AF and provide benefit for those detected earlier as a result of screening .
OBJECTIVES This review aims to answer the following questions .Does systematic screening increase the detection of AF compared with routine practice ?
Which combination of screening population , strategy and test is most effective for detecting AF compared with routine practice ?
What safety issues and adverse events may be associated with individual screening programmes ?
How acceptable is the intervention to the target population ?
What costs are associated with systematic screening for AF ?
Predicting the impact of the screening programme for colorectal cancer in the UK
Objectives Screening for colorectal cancer by biennial testing for faecal occult blood is being introduced in the UK from 2007 . We examine the likely impact of the programme , in terms of reduced mortality , lives saved and changes in incidence , over the next 20 years . Setting Projections of incidence and mortality of colorectal cancer in Engl and , and the policy that has been adopted for screening in Engl and ( biennial at ages 60–69 from 2007 , then 60–74 in 2010 ) . Methods The results are based on the output of a simulation model that has been used to examine cost-effectiveness of screening policy options , with two scenarios regarding compliance with screening ; both assume that 20 % of the population will never attend for screening , but attendance of those who do is modelled either as a r and om 60 % or 80 % , at each screening round . Results The decrease in mortality rates expected 20 years after introducing screening is 13–17 % in men and 12–15 % in women ( depending on the attendance levels ) . The model predicts an initial rise in incidence , followed ( after six to seven years ) by a fall , so that there is little net change in the number of cases detected over a 20-year period . Conclusion Percentage changes in mortality seem modest , but the projected saving in terms of numbers of lives is not negligible – 1800–2400 per year by 2025 in Engl and ( equivalent numbers are 2200–2700 in all over the UK ) . Newer screening modalities may improve on these projected results
Evidence suggests that systematic screening and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice .
Although these approaches have comparable effects on the overall AF diagnosis rate , the cost of systematic screening is significantly greater than the cost of opportunistic screening from the perspective of the health service provider .
BACKGROUND Atrial fibrillation ( AF ) , the most common arrhythmia in clinical practice , is a leading cause of morbidity and mortality .
Screening for AF in asymptomatic patients has been proposed as a way of reducing the burden of the disease by detecting people who would benefit from prophylactic anticoagulation therapy before the onset of symptoms .
However , for screening to be an effective intervention , it must improve the detection of AF and provide benefit for those detected earlier as a result of screening .
OBJECTIVES This review aims to answer the following questions .Does systematic screening increase the detection of AF compared with routine practice ?
Which combination of screening population , strategy and test is most effective for detecting AF compared with routine practice ?
What safety issues and adverse events may be associated with individual screening programmes ?
How acceptable is the intervention to the target population ?
What costs are associated with systematic screening for AF ?