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CARDIOVASCULAR SCREENING OF YOUNG ATHLETES: A REVIEW OF ECONOMIC EVALUATIONS

Published online by Cambridge University Press:  24 April 2017

Sophie Gerkens ,
Hans Van Brabandt ,
Anja Desomer ,
Christian Leonard  and
Mattias Neyt
Sophie Gerkens
Affiliation:
Belgian Health Care Knowledge Centre (KCE)sophie.gerkens@kce.fgov.be
Hans Van Brabandt
Affiliation:
Belgian Health Care Knowledge Centre (KCE)
Anja Desomer
Affiliation:
Belgian Health Care Knowledge Centre (KCE)
Christian Leonard
Affiliation:
Belgian Health Care Knowledge Centre (KCE)
Mattias Neyt
Affiliation:
Belgian Health Care Knowledge Centre (KCE)
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Abstract

Objectives: Some experts have promoted preparticipative cardiovascular screening programs for young athletes and have claimed that such programs were cost-effective without performing a critical analysis of studies supporting this statement. In this systematic review, a critical assessment of economic evaluations on these programs is performed to determine if they really provide value for money.

Methods: A systematic review of economic evaluations was performed on December 24, 2014. Web sites of health technology assessment agencies, the Cochrane database of systematic review, the National Health Service Economic Evaluation Database of the Cochrane Library, EMBASE, Medline, Psychinfo, and EconLit were searched to retrieve (reviews of) economic evaluations. No language or time restrictions were imposed and predefined selection criteria were used. Selected studies were critically assessed applying a structured data extraction sheet.

Results: Five relevant economic evaluations were critically assessed. Results of these studies were mixed. However, those in favor of screening made (methodological) incorrect choices, of which the most important one was not taking into account a no-screening alternative as comparator. Compared with no screening, other strategies (history and physical examination or history and physical examination plus electrocardiogram) were not considered cost-effective.

Conclusions: Results of primary economic evaluations should not be blindly copied without critical assessment. Economic evaluations in this field lack the support of robust evidence. Negative consequences of screening (false positive findings, overtreatment) should also be taken into account and may cause more harm than good. A mass screening of young athletes for cardiovascular diseases does not provide value for money and should be discouraged.

Keywords

Mass screeningCardiovascular diseasesDeathSuddenCardiacAthletesCosts and cost analysis
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 1 , 2017 , pp. 76 - 83
Copyright
Copyright © Cambridge University Press 2017 

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