Abdominal Aortic Aneurysm
Conditions
Brief summary
The 8-12 fold higher risk for sisters and brothers of patients with Abdominal Aortic Aneurysms (AAA) to develop AAA compared to persons in the population is well known in the scientific community. Recently the value of the screening program for siblings has been analyzed and is shown to be highly cost-efficient, similar to the population based screening of 65-year old men for AAA. Most importantly detection of siblings also adresses and includes women at risk. The adult offsprings to AAA patient would hypothetically bear the same risk of AAA as siblings. This has never been evaluated scientifically due to the practical difficulties in tracking the offspring and inviting them to screening at an age when they are at risk of AAA-disease. In Sweden, the unique multigeneration registry exists which could support such detection, with the possibility to track adult offspring to patients, and investigate the true contemporary prevalence in them. The DAAAD project aims at investigating the prevalence in adult offspring parallel to developing a model for such a selective screening program
Detailed description
This project will evaluate four questions 1. Feasibility of study design; can we evaluate the prevalence of AAA by inviting and detecting risk groups in national registries ? 2. Point prevalence of AAA in a riskgroup of adult offspring to AAA patients as compared to a matched control group 3. Quality of Life in risk groups: measuring HADS, EQ-5D and questionnaire on heredity, including their awareness on their risk for AAA 4. Cost-effectiveness of such a national program based on prevalence and EQ-5D This program will evaluate the risk for AAA in adult offspring and also evaluate a highly probable effective registry-based detection route. This could be more cost-efficient than any other AAA screening program, since the prevalence presumably is very high, and the registry-based route could be cheaper than nurse-based detection or incidental screening. The ultimate benefit of this program will be a crude reduction of sudden deaths from AAA for adult offspring to AAA patients, and this will be specifically impressive for the female relatives that are never subjected to any AAA-screening in our country.
Interventions
DIAGNOSTIC_TESTUltrasound and questionnaire
One invititation to identified adult offspring to have an ultrasound to detect an AAA. The prevalence in this Group (strata for sex) will be compared to a random selected matched Control group
Sponsors
Karolinska Institutet
Karolinska University Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
45 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Adult offspring to registered AAA parent (adult offspring) adult offspring not having a AAA parent (Controls) \-
Exclusion criteria
Not living in Stockholm below 45 or above 80
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of AAA | baseline | Ultrasound or CT 30 mm aortic diameter |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Awareness of hereditability and anxiety levels | baseline | Questionnaire based information |
Other
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of registry-based detection model for screening. | One year after baseline | Comparison can be made with the screening program in men. The outcome here is to explore if it is possible to implement this register model nationally at reasonable cost and work load. Participation rates, detailed analysis of non-participants in the risk group vs control group. Screening models are measured as feasible if participation \>50%. |
| Cost Effectiveness of program measured by quality-adjusted life-years | One year after baseline | Quality-adjusted life-years (QALYs) The prevalence in adult offspring, including cost of program, gives cost-effectiveness, probability of cost-effectiveness at different willingness-to-pay (WTP) thresholds, reduction in AAA death gained and total costs on a national scale. Presented as QUALY. |
Countries
Sweden
Outcome results
None listed