{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T02:44:47Z","timestamp":1766544287609,"version":"3.48.0"},"reference-count":25,"publisher":"BMJ","issue":"7041","license":[{"start":{"date-parts":[[1996,5,18]],"date-time":"1996-05-18T00:00:00Z","timestamp":832377600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1996,3,22]]},"published-print":{"date-parts":[[1996,5,18]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:bold>\n : To provide a commentary on the economic evaluations of the Oxcheck and British family heart studies: direct comparison of their relative effectiveness and cost effectiveness; comparisons with other interventions; and consideration of problems encountered.\n <\/jats:p>\n \n Design<\/jats:bold>\n : Modelling from cost and effectiveness data to estimates of cost per life year gained.\n <\/jats:p>\n \n Subjects<\/jats:bold>\n : Middle aged men and women.\n <\/jats:p>\n \n Interventions<\/jats:bold>\n : Screening for cardiovascular risk factors followed by appropriate lifestyle advice and drug intervention in general practice, and other primary coronary risk management strategies.\n <\/jats:p>\n \n Main outcome measures<\/jats:bold>\n : Life years gained; cost per life year gained.\n <\/jats:p>\n \n Results<\/jats:bold>\n : Depending on the assumed duration of risk reduction, the programme cost per discounted life year gained ranged from \u00a334 800 for a 1 year duration to \u00a31500 for 20 years for the British family heart study and from \u00a329 300 to \u00a3900 for Oxcheck. These figures exclude broader net clinical and cost effects and longer term clinical and cost effects other than coronary mortality.\n <\/jats:p>\n \n Conclusions<\/jats:bold>\n : Despite differences in underlying methods, the estimates in the two economic analyses of the studies can be directly compared. Neither study was large enough to provide precise estimates of the overall net cost. Modelling to cost per life year gained provides more readily interpretable measures. These estimates emphasise the importance of the relatively weak evidence on duration of effect. Only if the effect lasts at least five years is the Oxcheck programme likely to be cost effective. The effect must last for about 10 years to justify the extra cost associated with the British family heart study.\n <\/jats:p>\n \n \n \n Key messages<\/jats:title>\n \n \n A more meaningful measure, cost per life year gained, requires modelling of the longer term effect of that risk reduction<\/jats:p>\n <\/jats:list-item>\n \n In terms of life years gained, the more intensive British family heart study intervention was more effective but less cost effective than the Oxcheck intervention<\/jats:p>\n <\/jats:list-item>\n \n The cost effectiveness of these relative to other interventions crucially depends on the assumed duration of the risk reduction, which must persist for at least five years for either programme to be viewed as cost effective<\/jats:p>\n <\/jats:list-item>\n \n Larger trials with longer follow up would be required to fully assess the long term effectiveness and overall cost effectiveness of population cardiovascular screening<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n <\/jats:boxed-text>\n <\/jats:p>","DOI":"10.1136\/bmj.312.7041.1274","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:40:35Z","timestamp":1319744435000},"page":"1274-1278","source":"Crossref","is-referenced-by-count":46,"title":["What can be concluded from the Oxcheck and British family heart studies: commentary on cost effectiveness analyses"],"prefix":"10.1136","volume":"312","author":[{"given":"David","family":"Wonderling","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Langham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Buxton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Normand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"McDermott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,5,18]]},"reference":[{"key":"2025122309380006000_312.7041.1274.1","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1136\/bmj.308.6924.308","article-title":"Effectiveness of health checks conducted by nurses in primary care: results of the Oxcheck study after one year","volume":"308","year":"1994","journal-title":"BMJ"},{"key":"2025122309380006000_312.7041.1274.2","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1136\/bmj.310.6987.1099","article-title":"Effectiveness of health checks conducted by nurses in primary care: final results of the Oxcheck study","volume":"310","year":"1995","journal-title":"BMJ"},{"key":"2025122309380006000_312.7041.1274.3","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1136\/bmj.308.6924.313","article-title":"Randomised controlled trial evaluating cardiovascular screening and intervention in general practice: principal results of British family heart study","volume":"308","year":"1994","journal-title":"BMJ"},{"key":"2025122309380006000_312.7041.1274.4","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1136\/bmj.308.6924.285","article-title":"Screening for cardiovascular risk in general practice: blanket health promotion is a waste of resources [editorial]","volume":"308","author":"Stott","year":"1994","journal-title":"BMJ"},{"key":"2025122309380006000_312.7041.1274.5","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1136\/bmj.310.6987.1109","article-title":"Strategies for reducing coronary risk factors in primary care: which is most cost effective?","volume":"310","author":"Field","year":"1995","journal-title":"BMJ"},{"key":"2025122309380006000_312.7041.1274.6","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1136\/bmj.312.7041.1265","article-title":"Costs and cost-effectiveness of health checks conducted by nurses in primary care: the Oxcheck study","volume":"312","author":"Langham","year":"1996","journal-title":"BMJ"},{"key":"2025122309380006000_312.7041.1274.7","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1136\/bmj.312.7041.1269","article-title":"Costs and cost effectiveness of cardiovascular screening and intervention: the British family heart study","volume":"312","author":"Wonderling","year":"1996","journal-title":"BMJ"},{"key":"2025122309380006000_312.7041.1274.8","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1136\/bmj.303.6805.744","article-title":"The Dundee coronary risk disk for management of change in risk factors","volume":"303","author":"Tunstall-Pedoe","year":"1991","journal-title":"BMJ"},{"key":"2025122309380006000_312.7041.1274.9","unstructured":"Office of Population Censuses and Surveys . 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