LONDON (Reuters), Apr 26 - Examining patient records to pick out those at high risk of developing heart disease is cheaper and just as effective as screening all adults between ages 40 and 74, a British study showed on Monday.
The research, published in the British Medical Journal, raises doubts about a 250-million-pound ($387 million) a year screening program launched by the British government in 2008 and suggests funds may be better spent on high-risk patients.
Simon Griffin of the epidemiology unit of Britain's Medical Research Council, who led the study, said it showed with healthcare budgets squeezed by global recession and a growing burden of chronic disease, health authorities should think carefully about pricey heart screening plans.
"A universal screening program for cardiovascular disease might prevent an important number of new cardiovascular events ... but it may be unrealistic to implement in increasingly resource-constrained health systems," he wrote in the study.
Heart disease is the number one killer of men and women in Europe, the United States, and other developed nations. Its costs to the British economy are estimated at 30 billion pounds ($46.4 billion) a year, while the American Heart Association estimates heart disease and stroke will cost the United States an estimated $503.2 billion in 2010.
Griffin and colleagues assessed data from almost 17,000 European men and women between the ages of 40 and 74 who had no heart disease or diabetes at the start of the study.
They looked at several different screening strategies to determine which ones were most effective: Inviting all 40-74 year olds for vascular screening (as the British program does); inviting 50-74 year olds for screening; inviting overweight people for screening, asking patients to complete a heart disease risk questionnaire and inviting those with high scores for screening; and inviting only patients whose records would flag them up as high risk.
The researchers found that final strategy -- using medical records to pick out high-risk patients -- was just as effective as the government's screening program at preventing new cases of heart disease and would save costs.
Starting screening from age 50, rather than 40, would also get similar results, they found.
"Policymakers have to decide on the balance between the number of people needed to screen or treat and the number of (heart disease) cases that can be prevented," Griffin wrote.
Britain's opposition Conservative Party, seeking to oust Prime Minister Gordon Brown's Labor government in an election on May 6, has indicated it may scrap the vascular screening program if it wins power.
In a commentary on the study, Tom Marshall, a public health experts from the University of Birmingham, said he favored a more targeted approach.
"There are untreated patients at high risk of cardiovascular disease, most of whom can be identified from their electronic primary care records -- we should act on this information."
By Kate Kelland
Source: BMJ, online April 26, 2010.
Last Updated: 2010-04-26 10:53:19 -0400 (Reuters Health)
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