Economic value of remote screening for Atrial Fibrillation (AMALFI trial)

Screening for asymptomatic atrial fibrillation (AF) may increase AF detection and reduce cardioembolic stroke, but long-term efficacy and cost-effectiveness remain uncertain. The Active Monitoring for Atrial Fibrillation (AMALFI) trial has shown that remote AF screening with a mailed, non-invasive 14-day ambulatory ECG patch modestly increased AF diagnosis at 2.5 years, with further outcomes assessed at future 5-year follow-up. Whilst early outcomes indicate potential clinical benefits of long-term remote ECG screening, it is unclear whether the scale of improvement in clinical outcomes indicate the therapy to be a cost-effective use of scarce NHS resources.

We will be evaluating inpatient and outpatient costs and quality-adjusted survival of AMALFI trial participants at 2.5 and 5 years to estimate the potential economic impact of remote AF screening in the UK. Assessment of quality-adjusted survival is based on participant’s EQ-5D assessments and mortality records, whilst primary care and hospitalisation costs will be derived from linked health records at 2.5 and 5 years.

This work aims to inform national considerations of the value of atrial fibrillation screening programmes, and inform the value and design of future international randomised trials in this clinical area.