A 3-year extension to the Multi-centre Aneurysm Screening Study (MASS) for long-term clinical follow up.
Lead Research Organisation:
St Richard's Hospital
Department Name: Surgery
Abstract
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Technical Summary
Background
67 800 men were entered into the trial, 33,839 were randomly allocated to the ?invited for screening? arm. The abdominal aorta was scanned using ultrasound in 27,147 subjects and 1333 patients were found to have an abdominal aortic aneurysm (AAA) with an aortic diameter of 3 cm or greater. Follow up involved collecting data on mortality , all AAA operations, and sequential ultrasonographical (US) measurement in patients with a detected AAA. Information was collected on any subject who had AAA surgery, died from AAA, or who died of any other cause. Detailed data was collected on costs of screening and treatment, together with questionnaire data relating to health perception. The trial ran on target, within budget, and the initial results were published in November 2002. Results showed that death from AAA was significantly reduced in the screened group. Anxiety, depression and health status measures were within the population norms at all times and across all groups. At 4 years, the cost effectiveness for AAA screening was acceptable according to current NHS thresholds.
Objectives of the extension
1.To assess the long-term effectiveness,and cost-effectiveness of screening.
2.To assess the duration of benefit of a single scan.
3.To review the frequency of surveillance required for detected AAA in the light of additional information.
4. To assess the long term effect of screening on surgical workpoad
5. To obtain additional information on the natural history of the disease.
6. To assess long-term survival following AAA surgery .
7. To collect additional data for evidence based decisions to run an effective AAA screening programme.
Methods
* Mortality data will continue to be collected, linked to the Office of National Statistics (ONS) system, and the processes for obtaining copies of death certificates, entering data and analysing the results are in place and has already secured funding.
* Collection of AAA surgery data will continue, and staff remain in post, with experience in managing the office databases and extracting data from hospital records and information systems.
* Ultrasonographic reports will be retrieved from the medical imaging departments at each centre and added to the existing MASS databases.
* Endpoint data will be updated and entered into the databases already set up.
Relationships have been established with GP practices and hospital departments to enable continued data collection and prospective management of patients with AAA, using the trial criteria.
67 800 men were entered into the trial, 33,839 were randomly allocated to the ?invited for screening? arm. The abdominal aorta was scanned using ultrasound in 27,147 subjects and 1333 patients were found to have an abdominal aortic aneurysm (AAA) with an aortic diameter of 3 cm or greater. Follow up involved collecting data on mortality , all AAA operations, and sequential ultrasonographical (US) measurement in patients with a detected AAA. Information was collected on any subject who had AAA surgery, died from AAA, or who died of any other cause. Detailed data was collected on costs of screening and treatment, together with questionnaire data relating to health perception. The trial ran on target, within budget, and the initial results were published in November 2002. Results showed that death from AAA was significantly reduced in the screened group. Anxiety, depression and health status measures were within the population norms at all times and across all groups. At 4 years, the cost effectiveness for AAA screening was acceptable according to current NHS thresholds.
Objectives of the extension
1.To assess the long-term effectiveness,and cost-effectiveness of screening.
2.To assess the duration of benefit of a single scan.
3.To review the frequency of surveillance required for detected AAA in the light of additional information.
4. To assess the long term effect of screening on surgical workpoad
5. To obtain additional information on the natural history of the disease.
6. To assess long-term survival following AAA surgery .
7. To collect additional data for evidence based decisions to run an effective AAA screening programme.
Methods
* Mortality data will continue to be collected, linked to the Office of National Statistics (ONS) system, and the processes for obtaining copies of death certificates, entering data and analysing the results are in place and has already secured funding.
* Collection of AAA surgery data will continue, and staff remain in post, with experience in managing the office databases and extracting data from hospital records and information systems.
* Ultrasonographic reports will be retrieved from the medical imaging departments at each centre and added to the existing MASS databases.
* Endpoint data will be updated and entered into the databases already set up.
Relationships have been established with GP practices and hospital departments to enable continued data collection and prospective management of patients with AAA, using the trial criteria.