Cost-effectiveness and diagnostic accuracy of focused cardiac ultrasound in the pre-participation screening of athletes : the SPORT-FoCUS study
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
AIMS: The role of pre-participation screening (PPS) modalities in preventing sudden cardiac death (SCD) in athletes is debated due to a high false-positive rate. Focused cardiac ultrasound (FoCUS) has shown higher sensitivity and specificity, but its cost-effectiveness remains uncertain. This study aimed to determine the diagnostic performance and cost-effectiveness of FoCUS use in PPS.
METHODS AND RESULTS: A total of 2111 athletes (77.4% male, mean age 24.9 ± 15.2years) underwent standardized family and medical history collection, physical examination, resting electrocardiography (ECG), FoCUS (10 min/5 views protocol), comprehensive echocardiography and exercise stress test. We prospectively evaluated three PPS incremental models: Model A, standardized medical history and physical examination Model B, Model A plus resting and stress ECG and Model C, Model B plus FoCUS (10 min/5 views protocol). We determined their incremental diagnostic accuracy and cost-effectiveness ratio. A total of 30 athletes were diagnosed with a cardiac condition associated with SCD: 3 were identified by Model A, 14 by Model B, and 13 athletes by Model C. The introduction of FoCUS markedly increased the sensitivity of PPS, compared with Model A and Model B (sensitivity 94% vs. 19% vs. 58% specificity 93% vs. 93% vs. 92%). The total screening costs were as follows: Model A 35.64 euros, Model B 87.68 euros, and Model C 120.89 euros. Considering the sole conditions at risk of SCD, the incremental cost-effectiveness ratio was 135.62 euros for Model B and 114.31 for Model C.
CONCLUSIONS: The implementation of FoCUS into the PPS allows to identify a significantly greater number of athletes at risk of SCD and markedly lowers the false negative rate. Furthermore, the incorporation of FoCUS into the screening process has shown to be cost-effective.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
European journal of preventive cardiology - 30(2023), 16 vom: 09. Nov., Seite 1748-1757 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Halasz, Geza [VerfasserIn] |
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| Links: |
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| Themen: |
Athletes |
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| Anmerkungen: |
Date Completed 13.11.2023 Date Revised 29.11.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/eurjpc/zwad287 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM361660561 |
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| 245 | 1 | 0 | |a Cost-effectiveness and diagnostic accuracy of focused cardiac ultrasound in the pre-participation screening of athletes |b the SPORT-FoCUS study |
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| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a AIMS: The role of pre-participation screening (PPS) modalities in preventing sudden cardiac death (SCD) in athletes is debated due to a high false-positive rate. Focused cardiac ultrasound (FoCUS) has shown higher sensitivity and specificity, but its cost-effectiveness remains uncertain. This study aimed to determine the diagnostic performance and cost-effectiveness of FoCUS use in PPS | ||
| 520 | |a METHODS AND RESULTS: A total of 2111 athletes (77.4% male, mean age 24.9 ± 15.2years) underwent standardized family and medical history collection, physical examination, resting electrocardiography (ECG), FoCUS (10 min/5 views protocol), comprehensive echocardiography and exercise stress test. We prospectively evaluated three PPS incremental models: Model A, standardized medical history and physical examination Model B, Model A plus resting and stress ECG and Model C, Model B plus FoCUS (10 min/5 views protocol). We determined their incremental diagnostic accuracy and cost-effectiveness ratio. A total of 30 athletes were diagnosed with a cardiac condition associated with SCD: 3 were identified by Model A, 14 by Model B, and 13 athletes by Model C. The introduction of FoCUS markedly increased the sensitivity of PPS, compared with Model A and Model B (sensitivity 94% vs. 19% vs. 58% specificity 93% vs. 93% vs. 92%). The total screening costs were as follows: Model A 35.64 euros, Model B 87.68 euros, and Model C 120.89 euros. Considering the sole conditions at risk of SCD, the incremental cost-effectiveness ratio was 135.62 euros for Model B and 114.31 for Model C | ||
| 520 | |a CONCLUSIONS: The implementation of FoCUS into the PPS allows to identify a significantly greater number of athletes at risk of SCD and markedly lowers the false negative rate. Furthermore, the incorporation of FoCUS into the screening process has shown to be cost-effective | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Athletes | |
| 650 | 4 | |a Cost-effectiveness | |
| 650 | 4 | |a Focused cardiac ultrasound (FoCUS) | |
| 650 | 4 | |a Pre-participation screening | |
| 650 | 4 | |a Sport medicine | |
| 650 | 4 | |a Sudden cardiac death | |
| 700 | 1 | |a Capelli, Bruno |e verfasserin |4 aut | |
| 700 | 1 | |a Nardecchia, Alessia |e verfasserin |4 aut | |
| 700 | 1 | |a Cattaneo, Mattia |e verfasserin |4 aut | |
| 700 | 1 | |a Cassina, Tiziano |e verfasserin |4 aut | |
| 700 | 1 | |a Biasini, Vincenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Barbieri, Davide |e verfasserin |4 aut | |
| 700 | 1 | |a Villa, Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Beltrami, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Perone, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Villani, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Badini, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Gervasi, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Piepoli, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Via, Gabriele |e verfasserin |4 aut | |
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