Published 28 July 2009, doi:10.1136/bmj.b3040
Cite this as: BMJ 2009;339:b3040

Letters

Abdominal aortic aneurysm

Is screening cost effective?

The first 150 words of the full text of this article appear below.

The cost effectiveness of an intervention (especially in those aged 65 and over who are subject to the multiple effects of ageing on survival) should be determined by its effect on the overall survival of the intervention group compared with that of the control group and not on the difference in survival of those with the condition under study.

Some statistical sleight of hand that is said to correct for other comorbidities seems to have gone on in the Multicentre Aneurysm Screening Study (MASS),¹ but is incomprehensible to the non-statistician. However, I find it inconceivable that an intervention should be declared cost effective when the deaths from all causes were 10 274 (average age at death 75.4 years) in the intervention group and 10 481 (average age at death 75.0 years) in the control group. Presumably the groups were well matched for age and comorbidity but no mention is made . . . [Full text of this article]

¹ Stobhill Hospital, Glasgow G21 3UW

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This article has been cited by other articles:

• Lewis, L S. (2009). Deciding on whether to screen. BMJ 339: b3041-b3041 [Full text]  
• Thompson, S., Scott, A. (2009). Authors' reply. BMJ 339: b3043-b3043 [Full text]  

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