Pooled yield of screening was greater in males across all age strata .
Neither the choice of screening methodology or device , the geographical region , nor the screening setting influenced the detection rate of AF .
The main limitation of this study is there are insufficient data on sociodemographic variables of the population s and possible ascertainment biases to explain the variance in the sample s. CONCLUSIONS People with screen-detected AF are at elevated calculated stroke risk : above age 65 , the majority have a Class-1 OAC recommendation for stroke prevention , and > 70 % have ≥1 additional stroke risk factor other than age/sex .
BACKGROUND The precise age distribution and calculated stroke risk of screen-detected atrial fibrillation ( AF ) is not known .
Therefore , it is not possible to determine the number needed to screen ( NNS ) to identify one treatable new AF case ( NNS-Rx ) ( i.e. , Class-1 oral anticoagulation [ OAC ] treatment recommendation ) in each age stratum .
If the NNS-Rx is known for each age stratum , precise cost-effectiveness and sensitivity simulations can be performed based on the age distribution of the population /region to be screened .
Such calculations are required by national authorities and organisations responsible for health system budgets to determine the best age cutoffs for screening programs and decide whether programs of screening should be funded .
Therefore , we aim ed to determine the exact yield and calculated stroke-risk profile of screen-detected AF and NNS-Rx in 5-year age strata .
Cost-Effectiveness of a National Opportunistic Screening Program for Atrial Fibrillation in Ireland.
OBJECTIVES To evaluate the cost-effectiveness of a  national atrial fibrillation screening program in Irel and involving annual opportunistic pulse palpation of all those older than 65 years during general practitioner consultations , with an electrocardiogram being performed if an irregular pulse is detected . METHODS A probabilistic Markov model was used to simulate costs and clinical outcomes in a hypothetical cohort of men and women with and without screening over the course of 25 years , using a societal perspective . RESULTS Screening was associated with an incremental cost-effectiveness ratio of € 23,004/ quality -adjusted life-year compared with routine care . Nevertheless , if the relative risk of stroke and systematic embolism in screen-detected patients is more than 12 % lower than that in patients with atrial fibrillation identified through routine practice , then screening would not be considered cost-effective at a willingness-to-pay threshold of € 45,000/ quality -adjusted life-year . An analysis comparing alternative combinations of start age and screening interval found that less frequent screening with a later start age may be more cost-effective than an annual screening from age 65 years . CONCLUSIONS Annual opportunistic screening of men and women aged 65 years and older in primary care in Irel and is likely to be cost-effective using conventional willingness-to-pay thresholds , assuming that those detected through screening have a comparable stroke risk profile as those detected through routine practice . Raising the start age of screening or increasing the screening interval may improve the cost-effectiveness of a prospect i ve screening program
Pooled yield of screening was greater in males across all age strata .
Neither the choice of screening methodology or device , the geographical region , nor the screening setting influenced the detection rate of AF .
The main limitation of this study is there are insufficient data on sociodemographic variables of the population s and possible ascertainment biases to explain the variance in the sample s. CONCLUSIONS People with screen-detected AF are at elevated calculated stroke risk : above age 65 , the majority have a Class-1 OAC recommendation for stroke prevention , and > 70 % have ≥1 additional stroke risk factor other than age/sex .
BACKGROUND The precise age distribution and calculated stroke risk of screen-detected atrial fibrillation ( AF ) is not known .
Therefore , it is not possible to determine the number needed to screen ( NNS ) to identify one treatable new AF case ( NNS-Rx ) ( i.e. , Class-1 oral anticoagulation [ OAC ] treatment recommendation ) in each age stratum .
If the NNS-Rx is known for each age stratum , precise cost-effectiveness and sensitivity simulations can be performed based on the age distribution of the population /region to be screened .
Such calculations are required by national authorities and organisations responsible for health system budgets to determine the best age cutoffs for screening programs and decide whether programs of screening should be funded .
Therefore , we aim ed to determine the exact yield and calculated stroke-risk profile of screen-detected AF and NNS-Rx in 5-year age strata .