GrippePaysBasV1, Main, Exploration, bibRecord, 000039

Cost-effectiveness of screening for atrial fibrillation in primary care with a handheld, single-lead electrocardiogram device in the Netherlands.

Identifieur interne : 000039 ( Main/Exploration ); précédent : 000038; suivant : 000040

Cost-effectiveness of screening for atrial fibrillation in primary care with a handheld, single-lead electrocardiogram device in the Netherlands.

Auteurs : Maartje S. Jacobs [Pays-Bas] ; Femke Kaasenbrood [Pays-Bas] ; Maarten J. Postma [Pays-Bas] ; Marinus Van Hulst [Pays-Bas] ; Robert G. Tieleman [Pays-Bas]

Source :

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [ 1532-2092 ] ; 2018.

RBID : pubmed:27733465

Descripteurs français

English descriptors

KwdEn :
- Aged (MeSH), Atrial Fibrillation (diagnosis), Atrial Fibrillation (economics), Atrial Fibrillation (epidemiology), Atrial Fibrillation (therapy), Clinical Decision-Making (MeSH), Computer Simulation (MeSH), Cost Savings (MeSH), Cost-Benefit Analysis (MeSH), Decision Support Techniques (MeSH), Decision Trees (MeSH), Electrocardiography (economics), Electrocardiography (instrumentation), Female (MeSH), Health Care Costs (MeSH), Humans (MeSH), Influenza Vaccines (administration & dosage), Male (MeSH), Markov Chains (MeSH), Mass Screening (economics), Mass Screening (instrumentation), Models, Economic (MeSH), Netherlands (epidemiology), Point-of-Care Testing (economics), Predictive Value of Tests (MeSH), Primary Health Care (economics), Quality-Adjusted Life Years (MeSH), Reproducibility of Results (MeSH), Stroke (economics), Stroke (epidemiology), Stroke (prevention & control), Vaccination (MeSH).
MESH :
- chemical , administration & dosage : Influenza Vaccines.
- diagnosis : Atrial Fibrillation.
- economics : Atrial Fibrillation, Electrocardiography, Mass Screening, Point-of-Care Testing, Primary Health Care, Stroke.
- epidemiology : Atrial Fibrillation, Netherlands, Stroke.
- instrumentation : Electrocardiography, Mass Screening.
- prevention & control : Stroke.
- therapy : Atrial Fibrillation.
- Aged, Clinical Decision-Making, Computer Simulation, Cost Savings, Cost-Benefit Analysis, Decision Support Techniques, Decision Trees, Female, Health Care Costs, Humans, Male, Markov Chains, Models, Economic, Predictive Value of Tests, Quality-Adjusted Life Years, Reproducibility of Results, Vaccination.

Abstract

Aims

Atrial fibrillation (AF) is the most common arrhythmia and prevalence increases with age. Patients with AF have a high risk of stroke, and screening for AF is recommended in all people aged 65 years or older to identify patients eligible for stroke prevention. A handheld, single-lead electrocardiogram (ECG) device can be used for systematic screening in the population at risk. The objective of this study is to estimate the cost-effectiveness of screening for AF in primary care with the MyDiagnostick® during seasonal influenza vaccination in the Netherlands.

Methods and results

Lifetime costs and effects of a single screening session for AF detection were assessed from a societal perspective with a decision analytic model consisting of a straightforward decision tree and a joining Markov model. The decision model simulated all patients aged 65 years and over attending the seasonal influenza vaccination in the Netherlands. Event probabilities were derived from clinical trials. Sensitivity analyses were performed to assess the impact of important model assumptions as well as determining the relative effect of individual parameters. Screening for AF with the MyDiagnostick® in all patients older than 65 years that attend seasonal influenza vaccination in the Netherlands would decrease the overall costs by €764 and increase the quality-adjusted life-years (QALYs) by 0.27 years per patient. Early detection of AF would prevent strokes and leads to beneficial health effects with subsequent cost savings. This screening method would have an estimated probability of 99.8% for being cost-effective at a conservative willingness-to-pay of €20 000/QALY.

Conclusion

Screening for AF in primary care with a handheld, single-lead ECG during seasonal influenza vaccination is very likely to be cost saving for identifying new cases of AF in the Dutch population aged 65 years and over. Active screening for AF with a single-lead, handheld ECG device during seasonal influenza vaccination could be implemented in primary care.

DOI: 10.1093/europace/euw285
PubMed: 27733465

Affiliations:

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Atrial Fibrillation (diagnosis)</term>
<term>Atrial Fibrillation (economics)</term>
<term>Atrial Fibrillation (epidemiology)</term>
<term>Atrial Fibrillation (therapy)</term>
<term>Clinical Decision-Making (MeSH)</term>
<term>Computer Simulation (MeSH)</term>
<term>Cost Savings (MeSH)</term>
<term>Cost-Benefit Analysis (MeSH)</term>
<term>Decision Support Techniques (MeSH)</term>
<term>Decision Trees (MeSH)</term>
<term>Electrocardiography (economics)</term>
<term>Electrocardiography (instrumentation)</term>
<term>Female (MeSH)</term>
<term>Health Care Costs (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Influenza Vaccines (administration & dosage)</term>
<term>Male (MeSH)</term>
<term>Markov Chains (MeSH)</term>
<term>Mass Screening (economics)</term>
<term>Mass Screening (instrumentation)</term>
<term>Models, Economic (MeSH)</term>
<term>Netherlands (epidemiology)</term>
<term>Point-of-Care Testing (economics)</term>
<term>Predictive Value of Tests (MeSH)</term>
<term>Primary Health Care (economics)</term>
<term>Quality-Adjusted Life Years (MeSH)</term>
<term>Reproducibility of Results (MeSH)</term>
<term>Stroke (economics)</term>
<term>Stroke (epidemiology)</term>
<term>Stroke (prevention & control)</term>
<term>Vaccination (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Accident vasculaire cérébral (prévention et contrôle)</term>
<term>Accident vasculaire cérébral (économie)</term>
<term>Accident vasculaire cérébral (épidémiologie)</term>
<term>Analyse coût-bénéfice (MeSH)</term>
<term>Analyse sur le lieu d'intervention (économie)</term>
<term>Années de vie ajustées sur la qualité (MeSH)</term>
<term>Arbres de décision (MeSH)</term>
<term>Chaines de Markov (MeSH)</term>
<term>Coûts des soins de santé (MeSH)</term>
<term>Dépistage de masse (instrumentation)</term>
<term>Dépistage de masse (économie)</term>
<term>Femelle (MeSH)</term>
<term>Fibrillation auriculaire (diagnostic)</term>
<term>Fibrillation auriculaire (thérapie)</term>
<term>Fibrillation auriculaire (économie)</term>
<term>Fibrillation auriculaire (épidémiologie)</term>
<term>Humains (MeSH)</term>
<term>Modèles économiques (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Pays-Bas (épidémiologie)</term>
<term>Prise de décision clinique (MeSH)</term>
<term>Reproductibilité des résultats (MeSH)</term>
<term>Simulation numérique (MeSH)</term>
<term>Soins de santé primaires (économie)</term>
<term>Sujet âgé (MeSH)</term>
<term>Techniques d'aide à la décision (MeSH)</term>
<term>Vaccination (MeSH)</term>
<term>Vaccins antigrippaux (administration et posologie)</term>
<term>Valeur prédictive des tests (MeSH)</term>
<term>Économies (MeSH)</term>
<term>Électrocardiographie (instrumentation)</term>
<term>Électrocardiographie (économie)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Influenza Vaccines</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Vaccins antigrippaux</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Atrial Fibrillation</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Fibrillation auriculaire</term>
</keywords>
<keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Atrial Fibrillation</term>
<term>Electrocardiography</term>
<term>Mass Screening</term>
<term>Point-of-Care Testing</term>
<term>Primary Health Care</term>
<term>Stroke</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Atrial Fibrillation</term>
<term>Netherlands</term>
<term>Stroke</term>
</keywords>
<keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Electrocardiography</term>
<term>Mass Screening</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Stroke</term>
</keywords>
<keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Accident vasculaire cérébral</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Atrial Fibrillation</term>
</keywords>
<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Fibrillation auriculaire</term>
</keywords>
<keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Accident vasculaire cérébral</term>
<term>Analyse sur le lieu d'intervention</term>
<term>Dépistage de masse</term>
<term>Fibrillation auriculaire</term>
<term>Soins de santé primaires</term>
<term>Électrocardiographie</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Accident vasculaire cérébral</term>
<term>Fibrillation auriculaire</term>
<term>Pays-Bas</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Clinical Decision-Making</term>
<term>Computer Simulation</term>
<term>Cost Savings</term>
<term>Cost-Benefit Analysis</term>
<term>Decision Support Techniques</term>
<term>Decision Trees</term>
<term>Female</term>
<term>Health Care Costs</term>
<term>Humans</term>
<term>Male</term>
<term>Markov Chains</term>
<term>Models, Economic</term>
<term>Predictive Value of Tests</term>
<term>Quality-Adjusted Life Years</term>
<term>Reproducibility of Results</term>
<term>Vaccination</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Analyse coût-bénéfice</term>
<term>Années de vie ajustées sur la qualité</term>
<term>Arbres de décision</term>
<term>Chaines de Markov</term>
<term>Coûts des soins de santé</term>
<term>Femelle</term>
<term>Humains</term>
<term>Modèles économiques</term>
<term>Mâle</term>
<term>Prise de décision clinique</term>
<term>Reproductibilité des résultats</term>
<term>Simulation numérique</term>
<term>Sujet âgé</term>
<term>Techniques d'aide à la décision</term>
<term>Vaccination</term>
<term>Valeur prédictive des tests</term>
<term>Économies</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p><b>Aims</b>
</p>
<p>Atrial fibrillation (AF) is the most common arrhythmia and prevalence increases with age. Patients with AF have a high risk of stroke, and screening for AF is recommended in all people aged 65 years or older to identify patients eligible for stroke prevention. A handheld, single-lead electrocardiogram (ECG) device can be used for systematic screening in the population at risk. The objective of this study is to estimate the cost-effectiveness of screening for AF in primary care with the MyDiagnostick® during seasonal influenza vaccination in the Netherlands.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Methods and results</b>
</p>
<p>Lifetime costs and effects of a single screening session for AF detection were assessed from a societal perspective with a decision analytic model consisting of a straightforward decision tree and a joining Markov model. The decision model simulated all patients aged 65 years and over attending the seasonal influenza vaccination in the Netherlands. Event probabilities were derived from clinical trials. Sensitivity analyses were performed to assess the impact of important model assumptions as well as determining the relative effect of individual parameters. Screening for AF with the MyDiagnostick® in all patients older than 65 years that attend seasonal influenza vaccination in the Netherlands would decrease the overall costs by €764 and increase the quality-adjusted life-years (QALYs) by 0.27 years per patient. Early detection of AF would prevent strokes and leads to beneficial health effects with subsequent cost savings. This screening method would have an estimated probability of 99.8% for being cost-effective at a conservative willingness-to-pay of €20 000/QALY.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Conclusion</b>
</p>
<p>Screening for AF in primary care with a handheld, single-lead ECG during seasonal influenza vaccination is very likely to be cost saving for identifying new cases of AF in the Dutch population aged 65 years and over. Active screening for AF with a single-lead, handheld ECG device during seasonal influenza vaccination could be implemented in primary care.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27733465</PMID>
<DateCompleted><Year>2018</Year>
<Month>11</Month>
<Day>26</Day>
</DateCompleted>
<DateRevised><Year>2018</Year>
<Month>11</Month>
<Day>26</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1532-2092</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>20</Volume>
<Issue>1</Issue>
<PubDate><Year>2018</Year>
<Month>01</Month>
<Day>01</Day>
</PubDate>
</JournalIssue>
<Title>Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology</Title>
<ISOAbbreviation>Europace</ISOAbbreviation>
</Journal>
<ArticleTitle>Cost-effectiveness of screening for atrial fibrillation in primary care with a handheld, single-lead electrocardiogram device in the Netherlands.</ArticleTitle>
<Pagination><MedlinePgn>12-18</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1093/europace/euw285</ELocationID>
<Abstract><AbstractText Label="Aims">Atrial fibrillation (AF) is the most common arrhythmia and prevalence increases with age. Patients with AF have a high risk of stroke, and screening for AF is recommended in all people aged 65 years or older to identify patients eligible for stroke prevention. A handheld, single-lead electrocardiogram (ECG) device can be used for systematic screening in the population at risk. The objective of this study is to estimate the cost-effectiveness of screening for AF in primary care with the MyDiagnostick® during seasonal influenza vaccination in the Netherlands.</AbstractText>
<AbstractText Label="Methods and results">Lifetime costs and effects of a single screening session for AF detection were assessed from a societal perspective with a decision analytic model consisting of a straightforward decision tree and a joining Markov model. The decision model simulated all patients aged 65 years and over attending the seasonal influenza vaccination in the Netherlands. Event probabilities were derived from clinical trials. Sensitivity analyses were performed to assess the impact of important model assumptions as well as determining the relative effect of individual parameters. Screening for AF with the MyDiagnostick® in all patients older than 65 years that attend seasonal influenza vaccination in the Netherlands would decrease the overall costs by €764 and increase the quality-adjusted life-years (QALYs) by 0.27 years per patient. Early detection of AF would prevent strokes and leads to beneficial health effects with subsequent cost savings. This screening method would have an estimated probability of 99.8% for being cost-effective at a conservative willingness-to-pay of €20 000/QALY.</AbstractText>
<AbstractText Label="Conclusion">Screening for AF in primary care with a handheld, single-lead ECG during seasonal influenza vaccination is very likely to be cost saving for identifying new cases of AF in the Dutch population aged 65 years and over. Active screening for AF with a single-lead, handheld ECG device during seasonal influenza vaccination could be implemented in primary care.</AbstractText>
<CopyrightInformation>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jacobs</LastName>
<ForeName>Maartje S</ForeName>
<Initials>MS</Initials>
<AffiliationInfo><Affiliation>Department of Clinical Pharmacy and Toxicology, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of PharmacoTherapy, -Epidemiology & -Economics (PTEE), Department of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kaasenbrood</LastName>
<ForeName>Femke</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Postma</LastName>
<ForeName>Maarten J</ForeName>
<Initials>MJ</Initials>
<AffiliationInfo><Affiliation>Department of PharmacoTherapy, -Epidemiology & -Economics (PTEE), Department of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Institute for Science in Healthy Aging & healthcaRE (SHARE), University Medical Center Groningen (UMCG), University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>van Hulst</LastName>
<ForeName>Marinus</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Clinical Pharmacy and Toxicology, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of PharmacoTherapy, -Epidemiology & -Economics (PTEE), Department of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tieleman</LastName>
<ForeName>Robert G</ForeName>
<Initials>RG</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>Europace</MedlineTA>
<NlmUniqueID>100883649</NlmUniqueID>
<ISSNLinking>1099-5129</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001281" MajorTopicYN="N">Atrial Fibrillation</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
<QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000066491" MajorTopicYN="N">Clinical Decision-Making</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003198" MajorTopicYN="N">Computer Simulation</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017046" MajorTopicYN="N">Cost Savings</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003362" MajorTopicYN="N">Cost-Benefit Analysis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003661" MajorTopicYN="N">Decision Support Techniques</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003663" MajorTopicYN="N">Decision Trees</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004562" MajorTopicYN="N">Electrocardiography</DescriptorName>
<QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName>
<QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017048" MajorTopicYN="Y">Health Care Costs</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008390" MajorTopicYN="N">Markov Chains</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008403" MajorTopicYN="N">Mass Screening</DescriptorName>
<QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName>
<QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018803" MajorTopicYN="N">Models, Economic</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009426" MajorTopicYN="N">Netherlands</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000067716" MajorTopicYN="N">Point-of-Care Testing</DescriptorName>
<QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011237" MajorTopicYN="N">Predictive Value of Tests</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011320" MajorTopicYN="N">Primary Health Care</DescriptorName>
<QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019057" MajorTopicYN="N">Quality-Adjusted Life Years</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015203" MajorTopicYN="N">Reproducibility of Results</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D020521" MajorTopicYN="N">Stroke</DescriptorName>
<QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
<QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Atrial fibrillation</Keyword>
<Keyword MajorTopicYN="Y">Cost-effectiveness</Keyword>
<Keyword MajorTopicYN="Y">Health economic modelling</Keyword>
<Keyword MajorTopicYN="Y">Primary care</Keyword>
<Keyword MajorTopicYN="Y">Screening</Keyword>
<Keyword MajorTopicYN="Y">Single-lead ECG</Keyword>
<Keyword MajorTopicYN="Y">Stroke prevention</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year>
<Month>05</Month>
<Day>26</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2016</Year>
<Month>08</Month>
<Day>13</Day>
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<PubMedPubDate PubStatus="pubmed"><Year>2016</Year>
<Month>10</Month>
<Day>14</Day>
<Hour>6</Hour>
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<PubMedPubDate PubStatus="medline"><Year>2018</Year>
<Month>11</Month>
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<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">27733465</ArticleId>
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</pubmed>
<affiliations><list><country><li>Pays-Bas</li>
</country>
<region><li>Groningue (province)</li>
</region>
<settlement><li>Groningue (ville)</li>
</settlement>
<orgName><li>Université de Groningue</li>
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</list>
<tree><country name="Pays-Bas"><noRegion><name sortKey="Jacobs, Maartje S" sort="Jacobs, Maartje S" uniqKey="Jacobs M" first="Maartje S" last="Jacobs">Maartje S. Jacobs</name>
</noRegion>
<name sortKey="Jacobs, Maartje S" sort="Jacobs, Maartje S" uniqKey="Jacobs M" first="Maartje S" last="Jacobs">Maartje S. Jacobs</name>
<name sortKey="Kaasenbrood, Femke" sort="Kaasenbrood, Femke" uniqKey="Kaasenbrood F" first="Femke" last="Kaasenbrood">Femke Kaasenbrood</name>
<name sortKey="Postma, Maarten J" sort="Postma, Maarten J" uniqKey="Postma M" first="Maarten J" last="Postma">Maarten J. Postma</name>
<name sortKey="Postma, Maarten J" sort="Postma, Maarten J" uniqKey="Postma M" first="Maarten J" last="Postma">Maarten J. Postma</name>
<name sortKey="Postma, Maarten J" sort="Postma, Maarten J" uniqKey="Postma M" first="Maarten J" last="Postma">Maarten J. Postma</name>
<name sortKey="Tieleman, Robert G" sort="Tieleman, Robert G" uniqKey="Tieleman R" first="Robert G" last="Tieleman">Robert G. Tieleman</name>
<name sortKey="Tieleman, Robert G" sort="Tieleman, Robert G" uniqKey="Tieleman R" first="Robert G" last="Tieleman">Robert G. Tieleman</name>
<name sortKey="Van Hulst, Marinus" sort="Van Hulst, Marinus" uniqKey="Van Hulst M" first="Marinus" last="Van Hulst">Marinus Van Hulst</name>
<name sortKey="Van Hulst, Marinus" sort="Van Hulst, Marinus" uniqKey="Van Hulst M" first="Marinus" last="Van Hulst">Marinus Van Hulst</name>
</country>
</tree>
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Cost-effectiveness of screening for atrial fibrillation in primary care with a handheld, single-lead electrocardiogram device in the Netherlands.

Cost-effectiveness of screening for atrial fibrillation in primary care with a handheld, single-lead electrocardiogram device in the Netherlands.

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