Systematic review of guidelines on abdominal aortic aneurysm screening

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Presentation transcript:

Systematic review of guidelines on abdominal aortic aneurysm screening Bart S. Ferket, MD, Nathalie Grootenboer, MD, MSc, Ersen B. Colkesen, MD, Jacob J. Visser, MD, PhD, Marc R.H.M. van Sambeek, MD, PhD, Sandra Spronk, PhD, Ewout W. Steyerberg, PhD, M.G. Myriam Hunink, MD, PhD Journal of Vascular Surgery Volume 55, Issue 5, Pages 1296-1304.e4 (May 2012) DOI: 10.1016/j.jvs.2010.10.118 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Literature search and selection. Numbers of guidelines of each step of the process are indicated. Group totals may exceed the reported numbers for the excluded articles at abstract and full text level because several reasons for exclusion were allowed. AAA, Abdominal aortic aneurysm; CMA, Canadian Medical Association; NGC, National Guideline Clearinghouse. Journal of Vascular Surgery 2012 55, 1296-1304.e4DOI: (10.1016/j.jvs.2010.10.118) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Summarizing screening algorithm and suggestions for future research. a Restricting this target group by adding a history of smoking requires the reduced life expectancy caused by smoking to be taken into consideration in decision analysis. b Multivariable modeling to predict abdominal aortic aneurysm (AAA) risk can be used to identify groups at high risk within men 50 to 65 years, men >75 years, and women >60 years. Variables to consider are age, gender, family history of AAA, history of smoking, history of cardiovascular disease, other cardiovascular risk factors.14,18 The expected benefit of screening these groups can be calculated by decision analysis. c Prediction models considering variables such as age, gender, aortic diameter size, smoking status, blood pressure, history of cardiovascular disease, pulmonary and renal impairment can estimate these risks.23-25 d The optimal intervals for periodic ultrasound scan surveillance can be calculated with cost-effectiveness analysis. Journal of Vascular Surgery 2012 55, 1296-1304.e4DOI: (10.1016/j.jvs.2010.10.118) Copyright © 2012 Society for Vascular Surgery Terms and Conditions