Dr. Erika Kancler
Objective: Determine whether routine abdominal ultrasound screening in all men ages 65 and over, not just those who are symptomatic or at risk, would be beneficial in reducing the mortality rate from abdominal aortic aneurysms (AAA). Design: Systematic literature review. Methods: The clinical question investigated is whether routine ultrasound screening of AAA for men over age 65 reduces AAA-related mortality as compared to not routinely screening. Searches were done through PubMed using the keywords: screening, abdominal aortic aneurysm, reduce, and mortality. Citations used by the USPSTF AAA screening guidelines were also added to the literature search. In PubMed, further limitations were made by eliminating those that did not discuss screening and subsequent diagnosis of AAA, as well as full-text articles that did not discuss screening of males over 65 years old or if they were not clinical trials or systematic reviews. Eventually, only randomized controlled trials were included for analysis. Results: Randomized controlled trials conducted by Norman et al, Ashton et al, and Scott et al, were all chosen for analysis as they met the inclusion/exclusion criteria for the proposed clinical question. Studies by Norman et al, Ashton et al, and Scott et al estimated the numbers needed to screen at 1,393, 709, and 466 respectively. Conclusion: All of the studies clearly demonstrate a decrease in AAA-related mortality when routinely screening men greater than 65 years by ultrasound for AAA. However, the cost effectiveness of the suggested screening regimen as compared to the overall benefits of said screening warrants further investigation.
Nowak CE. Routine screening for abdominal aortic aneurysm: is it for everyone? JMU Scholarly Commons Physician Assistant Capstones. http://commons.lib.jmu.edu/pacapstones/11/. Published August 1, 2016.