| Effectiveness and cost-effectiveness of blood pressure screening in adolescents in the United States. | |
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MedLine Citation:
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PMID: 20850759 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the long-term effectiveness and cost-effectiveness of 3 approaches to managing elevated blood pressure (BP) in adolescents in the United States: no intervention, "screen-and-treat," and population-wide strategies to lower the entire BP distribution. STUDY DESIGN: We used a simulation model to combine several data sources to project the lifetime costs and cardiovascular outcomes for a cohort of 15-year-old U.S. adolescents under different BP approaches and conducted cost-effectiveness analysis. We obtained BP distributions from the National Health and Nutrition Examination Survey 1999-2004 and used childhood-to-adult longitudinal correlation analyses to simulate the tracking of BP. We then used the coronary heart disease policy model to estimate lifetime coronary heart disease events, costs, and quality-adjusted life years (QALY). RESULTS: Among screen-and-treat strategies, finding and treating the adolescents at highest risk (eg, left ventricular hypertrophy) was most cost-effective ($18000/QALY [boys] and $47000/QALY [girls]). However, all screen-and-treat strategies were dominated by population-wide strategies such as salt reduction (cost-saving [boys] and $650/QALY [girls]) and increasing physical education ($11000/QALY [boys] and $35000/QALY [girls]). CONCLUSIONS: Routine adolescents BP screening is moderately effective, but population-based BP interventions with broader reach could potentially be less costly and more effective for early cardiovascular disease prevention and should be implemented in parallel. |
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Authors:
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Y Claire Wang; Angela M Cheung; Kirsten Bibbins-Domingo; Lisa A Prosser; Nancy R Cook; Lee Goldman; Matthew W Gillman |
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Publication Detail:
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Type: Journal Article Date: 2010-09-17 |
Journal Detail:
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Title: The Journal of pediatrics Volume: 158 ISSN: 1097-6833 ISO Abbreviation: J. Pediatr. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: United States |
Other Details:
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Languages: eng Pagination: 257-264.e7 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Health Policy and Management, Columbia Mailman School of Public Health, New York, NY. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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