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    The things to come of SHAPE: cost and effectiveness of cardiovascular prevention

    April 28th, 2007

    Diamond GA, Kaul S. Am J Cardiol. 2007 Apr 1;99(7):1013-5. Epub 2007 Feb 15.

    It has been proposed recently that asymptomatic adults undergo routine screening
    for subclinical atherosclerosis using electron-beam computed tomography or
    carotid ultrasound as the basis for the pharmacologic prevention of
    cardiovascular events. The expected cost and effectiveness of this conditional
    test-treatment strategy are herein analyzed in comparison with the conventional
    conditional strategy, based on Framingham risk factor assessment, and with an
    unconditional treatment strategy that does not rely on testing. These analyses
    show that the unconditional treatment strategy, albeit more costly, is more
    effective and more cost-effective than either conditional testing strategy. In
    conclusion, greater attention should be paid to improving the population-wide
    delivery of and long-term adherence to proven preventive therapy than to the
    identification of “high-risk” treatment targets.  more…


     

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