Highlights


October 12th, 2011

posted Sep 5, 2011, 3:31 AM by ART ART   [ updated Oct 17, 2011, 3:47 AM ]


Bob van Kempen received the NIHES Master of Science Award 2011 for the best Master's thesis written in his year during the graduation ceremony in 'de Doelen' in Rotterdam. The manuscript was published in the 'Journal of the American College of Cardiology' on October 12th.


Coronary artery calcium screening is probably cost-effective in men, but unlikely in women.

Introduction

In an ongoing effort to prevent cardiovascular disease (CVD), clinicians have to distinguish individuals who are very likely to get a heart attack or stroke in the future, from those who have a low risk of developing these diseases. Individuals at high risk can benefit from cardioprotective treatment such as statins and aspirin. Guidelines on prevention of CVD recommend traditional risk factors such as blood pressure and cholesterol levels to be used to predict someone’s future risk of CVD. These predictions are not perfect – they sometimes over- or underestimates an individual’s true risk of disease. Earlier research has shown that using the results of a CT scan which measures the amount of calcium in the coronary arteries, substantially improves these predictions. What was unknown before our study was whether the improved prediction –by screening individuals with CT, would lead to more lives saved against acceptable costs.

Methods 
In order to address this question, we developed a computer-simulation model using data from the Rotterdam Study, a population based cohort study. We compared CT coronary calcium screening with a number of important alternatives - current practice as observed in the Rotterdam Study, full implementation of current CVD prevention guidelines and statin therapy for all individuals. Asymptomatic study participants were simulated over their remaining lifetime. We calculated the life expectancy of these individuals for all alternatives, taking into account their quality of life and lifetime costs. We focused on individuals at intermediate risk of coronary heart disease.

Results

We found that in men, CT coronary calcium screening increased the (quality adjusted) life expectancy compared to the other 3 strategies, but also cost more. In fact, screening men for coronary calcium with CT would cost about $50,000 per quality adjusted life year gained. In women things were different. Similarly to men, CT coronary calcium screening increased life expectancy and was more costly compared to current practice and statin therapy in women. However, fully implementing current CVD prevention guidelines was even more effective compared to CT coronary calcium screening in women, and only a little more expensive. Analysis of uncertainty revealed that there was considerable uncertainty about the value of CT screening in men. In women, results were more robust.   

Conclusions 
From our modeling study, we conclude that screening for coronary artery calcium with a CT scan in asymptomatic individuals at intermediate risk of CHD is probably cost-effective in men, but unlikely to be cost-effective in women. 

December 9, 2010

posted Dec 10, 2010, 1:18 AM by Loes Braun   [ updated Dec 10, 2010, 1:22 AM ]

Ineke van den Berg defended her thesis 'The Contribution of Acupuncture and Moxibustion to Healthcare: an Evidence-based Approach' successfully.

September 10, 2010

posted Dec 3, 2010, 1:02 AM by Loes Braun   [ updated Dec 3, 2010, 1:10 AM ]

Bob van Kempen received one of the three travel grants from the Dutch Royal Academy of Sciences (KNAW) for his PhD project on primary prevention of cardiovascular disease, during the official ceremony in the Arminius Church in Rotterdam.

August 27, 2010

posted Dec 3, 2010, 1:01 AM by Loes Braun   [ updated Dec 3, 2010, 1:10 AM ]

Raluca Mihaescu received the NIHES award for best paper written under the guidance of a NIHES tutor during the academic year of 2009 - 2010. Her paper, "Evaluation of risk prediction updates from commercial genome-wide scans." was published in Genetics in Medicine, August 2009. see: PubMED

June 2, 2010

posted Dec 3, 2010, 1:00 AM by Loes Braun   [ updated Dec 3, 2010, 1:10 AM ]

Myriam Hunink received the Award for Outstanding Short Course at the 2010 European meeting of the Society for Medical Decision Making for her workshop on Presentation Skills. 

January 18, 2010

posted Dec 3, 2010, 1:00 AM by Loes Braun   [ updated Dec 3, 2010, 1:09 AM ]

Bart Ferket was interviewed by theHeart.org on his article "Systematic review of guidelines on cardiovascular risk assessment: Which recommendations should clinicians follow for a cardiovascular health check?". Click here to read the report.

September 8, 2009

posted Dec 3, 2010, 12:59 AM by Loes Braun   [ updated Dec 3, 2010, 1:09 AM ]

Bob van Kempen received the KNAW-fellowship 2009 for his project on the cost-effectiveness of screening and prevention of coronary heart disease in an elderly population by Computed Tomography Calcium Scoring. see: KNAW

August 28, 2009

posted Dec 3, 2010, 12:58 AM by Loes Braun   [ updated Dec 3, 2010, 1:09 AM ]

Tessa Genders received the NIHES award for best paper written under the guidance of a NIHES tutor during the academic year of 2008 - 2009. Her paper, "Computed Tomography Coronary Angiography in Patients with Suspected Coronary Artery Disease: decision making from various perspectives in the face of uncertainty" will be published in Radiology, December 2009. see: PubMED

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