Diagnostic Yield and Financial Implications of a Nationwide Electrocardiographic Screening Programme to Detect Cardiac Disease in the Young
Overview
Physiology
Authors
Affiliations
Aims: There is limited information on the role of screening with electrocardiography (ECG) for identifying cardiovascular diseases associated with sudden cardiac death (SCD) in a non-select group of adolescents and young adults in the general population.
Methods And Results: Between 2012 and 2014, 26 900 young individuals (aged 14-35 years) were prospectively evaluated with a health questionnaire and ECG. Individuals with abnormal results underwent secondary investigations, the costs of which were being based on the UK National Health Service tariffs. Six hundred and seventy-five (2.5%) individuals required further investigation for an abnormal health questionnaire, 2175 (8.1%) for an abnormal ECG, and 114 (0.5%) for both. Diseases associated with young SCD were identified in 88 (0.3%) individuals of which 15 (17%) were detected with the health questionnaire, 72 (81%) with ECG and 2 (2%) with both. Forty-nine (56%) of these individuals received medical intervention beyond lifestyle modification advice in the follow-up period of 24 months. The overall cost of the evaluation process was €97 per person screened, €17 834 per cardiovascular disease detected, and €29 588 per cardiovascular disease associated with SCD detected. Inclusion of ECG was associated with a 36% cost reduction per diagnosis of diseases associated with SCD compared with the health questionnaire alone.
Conclusion: The inclusion of an ECG to a health questionnaire is associated with a five-fold increase in the ability to detect disease associated with SCD in young individuals and is more cost effective for detecting serious disease compared with screening with a health questionnaire alone.
Artificial intelligence for ventricular arrhythmia capability using ambulatory electrocardiograms.
Barker J, Li X, Kotb A, Mavilakandy A, Antoun I, Thaitirarot C Eur Heart J Digit Health. 2024; 5(3):384-388.
PMID: 38774363 PMC: 11104464. DOI: 10.1093/ehjdh/ztae004.
Bhatia R, Forster J, Ackrill M, Chatrath N, Finocchiaro G, Fyyaz S Echo Res Pract. 2024; 11(1):5.
PMID: 38383464 PMC: 10882860. DOI: 10.1186/s44156-024-00041-4.
Li L, Yu K, Mo Z, Yang K, Chen F, Yang J Molecules. 2023; 28(4).
PMID: 36838533 PMC: 9964326. DOI: 10.3390/molecules28041544.
Sudden Cardiac Death in Young Individuals: A Current Review of Evaluation, Screening and Prevention.
Abbas R, Abbas A, Khan T, Sharjeel S, Amanullah K, Irshad Y J Clin Med Res. 2023; 15(1):1-9.
PMID: 36755763 PMC: 9881489. DOI: 10.14740/jocmr4823.
ECG evaluation in 11 949 Italian teenagers: results of screening in secondary school.
Mancone M, Maestrini V, Fusto A, Adamo F, Scarparo P, DAmbrosi A J Cardiovasc Med (Hagerstown). 2021; 23(2):98-105.
PMID: 34570036 PMC: 8855949. DOI: 10.2459/JCM.0000000000001259.