CHDS’ Jinyi Zhu and Ankur Pandya modeled targeted screening for asymptomatic carotid artery stenosis (ACAS) to assess cost-effectiveness in preventing ischemic stroke. Fourteen percent of strokes are caused by thromboembolism from previously asymptomatic stenosis. A possible screening method is duplex ultrasonography (DUS) but its effectiveness and risks are not fully understood. DUS screening can identify asymptomatic patients with severe stenosis, which is then confirmed by CT scan or MRI and the patient is referred for revascularization treatment.
The investigators built a microsimulation model of ACAS and stroke for US adults aged 50-80 years without prior history of stroke or transient ischemic attack. The model showed that screening is cost-effective only for adults at high risk for atherosclerotic cardiovascular disease (ASCVD) and could substantially reduce lifetime stroke burden for such adults. For adults at lower risk of ASCVD, they found that screening was not cost-effective and offered minimal health benefits.
The research team included CHDS students Janice Jhang and Hanxuan Yu, as well as CHDS affiliate John Giardina.
Learn more: Read the full article, Cost-Effectiveness of Risk-Based Screening for Asymptomatic Carotid Artery Stenosis
Learn more: Explore the CHDS approach to Models and Tools
Learn more: Watch the CHDS interview with Ankur Pandya, Cost-Effectiveness Analysis and Model Choice
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