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The German Coronary Artery Disease Risk Screening Model: Development, Validation, and Application of a Decision-Analytic Model for Coronary Artery Disease Prevention with Statins

Author

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  • Björn Stollenwerk

    (Helmholtz Zentrum München (GmbH), Institute of Health Economics and Health Care Management, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany, bjoern.stollenwerk@helmholtz-muenchen.de)

  • Andreas Gerber
  • Karl W. Lauterbach
  • Uwe Siebert

Abstract

Background. Coronary artery disease (CAD) is a major cause of death in industrial countries, leading to high health-related costs and decreased quality of life. Objective. To develop and validate a decision-analytic model for CAD risk screening in Germany (German Coronary Artery Disease Screening Model). Design. Markov model. Target Population. Age- and gender-specific cohorts of the German population. Data Sources. Mortality rates posted by the German Federal Statistical Office, the German Health Survey, social health insurance institutions, the MONICA Augsburg study, and the literature. Time Horizon. Lifetime. Interventions. CAD risk screening for high-risk individuals using Framingham risk equation and use of statins as the primary preventive measure, compared with a setting without screening. Outcome Measures. Life-years (LY) gained, quality-adjusted life-years (QALYs) gained. Results. The model-based CAD incidence corresponds well with empirical data from the MONICA Augsburg study. Health outcomes depend on the screening threshold (cutoff value of Framingham 10-year risk) and on the age and gender of the cohort screened (0.03 to 0.26 LYs and 0.06 to 0.42 QALYs gained per person screened in cohorts of 50- and 60-year-old men and women, respectively). Conclusions. The model provides a valid tool for evaluating the long-term effectiveness of CAD risk screening in Germany. Using statins as a primary prevention intervention for CAD in high-risk individuals identified by screening could improve the long-term health of the German population.

Suggested Citation

  • Björn Stollenwerk & Andreas Gerber & Karl W. Lauterbach & Uwe Siebert, 2009. "The German Coronary Artery Disease Risk Screening Model: Development, Validation, and Application of a Decision-Analytic Model for Coronary Artery Disease Prevention with Statins," Medical Decision Making, , vol. 29(5), pages 619-633, September.
    • Handle: RePEc:sae:medema:v:29:y:2009:i:5:p:619-633
    DOI: 10.1177/0272989X09331810
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    Cited by:

    1. Sabine Witt & Reiner Leidl & Christian Becker & Rolf Holle & Michael Block & Johannes Brachmann & Sigmund Silber & Björn Stollenwerk, 2014. "The Effectiveness of the Cardiovascular Disease Prevention Programme ‘KardioPro’ Initiated by a German Sickness Fund: A Time-to-Event Analysis of Routine Data," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-17, December.
    2. Björn Stollenwerk & Afschin Gandjour & Markus Lüngen & Uwe Siebert, 2013. "Accounting for increased non-target-disease-specific mortality in decision-analytic screening models for economic evaluation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 1035-1048, December.
    3. Yanmei Liu & Koustuv Dalal & Björn Stollenwerk, 2013. "The Association between Health System Development and the Burden of Cardiovascular Disease: An Analysis of WHO Country Profiles," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-7, April.

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