Short summary

This is an intersectional and interdisciplinary screening program in Viborg Municipality, including 67 years old citizens. This observational study will estimate the cost-effectiveness of a combined screening program for the following conditions: Abdominal aortic aneurysm, peripheral arterial disease, carotid plaque, hypertension, arrhythmia, type-2-diabetes and chronic obstructive pulmonary disease. Furthermore, the incidence of the outlined conditions will be described and so will the result of the intervention initiated (secondary medical prophylaxis, smoking cessation, introduction to nutritionally deficient diet etc.)

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Rationale

In marts 2014 the screening program achieved political approval and financial support from the local committee of health in Viborg Municipality. In august 2014 the first citizens was screened .The program is intended to run for the next 5 years and is integrated in the Viborg Municipality overall prophylactic actions to improve the public health in general. Two screening nurses run the examination itself and handle the contact with the citizens. In addition, the screening program has a steering committee with representatives from the Municipality and a wide range of clinical experts. The clinical experts are responsible for the training of the screening nurses, establishment of a database and communication of the results.

The screenings program aims to identify conditions which increase the collectively morbidity and mortality significant and by early detection to initiate prophylactic initiatives (secondary medical prophylaxis, smoking cessation, introduction to nutritionally deficient diet etc.). By these actions, we expect the detected conditions long-term consequences to decrease and thereby to achieve a superior state of health and quality of life for the participating citizens. Secondarily, to decrease their future needs for health benefit.

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Description of the cohort

All Viborg municipality citizen are invited to the combined screening program around there 67^th birthday. Participants with positive screening results are offered following up consultations and prophylactic interventions are initiated (secondary medical prophylaxis, smoking cessation, introduction to nutritionally deficient diet etc.)

67 years-old citizens from the surrounding municipalities without the offer of the combined screening are used as a control group (1 case: 5 controls).

There are no exclusion criteria.

Data and biological material

The screening examination includes: Blood pressure in both arms, ankle brachial blood pressure index (ABI), ultrasound for carotid plaque and abdominal aortic aneurysm, HbA1c and pulmonary function test. Furthermore, a questionnaire on lifestyle parameters, BMI, medical history, walking-related pain and self-rated quality of life (EQ-5D).

One year after the screening examination, the participants will receive a questionnaire in order to evaluate the effect from a participant perspective. The cost(-effectiveness) of the screening program will be estimated after 5 years based on prevalence of diseases, response rate, data extraction from nationwide registries and existing evidence of disease prevention.

Collaborating researchers and departments

Cardiovascular Research Unit, Regional Hospital Viborg

• Associated professor Annette Høgh, MD, PhD
• PhD-student Marie Dahl Thomsen, MSc
• Associated professor Jens Refsgaard, MD, PhD
• Dorthe Møller, PhD

Department for Public Health, Aarhus University

• Professor of Health Economics Rikke Søgaard

Department of respiratory medicine, Regional Hospital Viborg

• Michael Skov, MD, PhD

Department of Vascular Surgery, Odense University Hospital

• General Practice coordinator Niels Jørgen Moeslund, MD

Viborg Municipality, the Health Center

• Marianne Toppenberg, Head of the Health Center, Viborg
• Mette Rohde, Head of the Health Care system, Viborg Council
• Pernille Lynggaard, Screening nurse
• Tina Damgaard, Screening nurse

Cardiovascular Research Unit, Regional Hospital Viborg

Department of Vascular Surgery, Odense University Hospital

• Professor Jes S. Lindholt, MD, PhD