{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:54:20Z","timestamp":1777434860366,"version":"3.51.4"},"reference-count":41,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The foundation of Rosa og Asta\n                                    Jensen, Viborg Regional Hospital, Denmark","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"The Health Resarch of Central\n                                    Denmark","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>The prevalence of cardiovascular disease (CVD) is increasing.\n                            Furthermore, asymptomatic individuals may not receive timely preventive\n                            initiatives to minimise the risk of further CVD events. Paradoxically,\n                            80% of CVD events are preventable by early detection, followed by\n                            prophylactic initiatives. Consequently, we introduced the\n                            population-based Viborg Screening Programme (VISP) for subclinical and\n                            manifest CVD, focusing on commonly occurring, mainly asymptomatic\n                            conditions, followed by prophylactic initiatives.<\/jats:p>\n                        <jats:p>The aim of the VISP was to evaluate the health benefits, harms and\n                            cost-effectiveness of the VISP from a healthcare sector perspective.\n                            Furthermore, we explored the participants\u2019 perspectives.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Methods and analysis<\/jats:title>\n                        <jats:p>From August 2014 and currently ongoing, approximately 1100 men and\n                            women from the Viborg municipality, Denmark, are annually invited to\n                            screening for abdominal aortic aneurysm, peripheral arterial disease,\n                            carotid plaque, hypertension, diabetes mellitus and cardiac arrhythmia\n                            on their 67th birthday. A population from the surrounding municipalities\n                            without access to the VISP acts as a control. The VISP invitees and the\n                            controls are followed on the individual level by nationwide registries.\n                            The primary outcome is all-cause mortality, while costs,\n                            hospitalisations and deaths from CVD are the secondary\n                            endpoints.<\/jats:p>\n                        <jats:p>Interim evaluations of effectiveness and cost-effectiveness are\n                            planned every 5 years using propensity score matching followed by a Cox\n                            proportional hazards regression analysis by the \u2018intention-to-treat\u2019\n                            principle. Furthermore, censoring-adjusted incremental costs, life-years\n                            and quality-adjusted life-years are estimated. Finally, the\n                            participants\u2019 perspectives are explored by semistructured face-to-face\n                            interviews, with participant selection representing participants with\n                            both negative and positive screening results.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Ethics and dissemination<\/jats:title>\n                        <jats:p>The VISP is not an interventional trial. Therefore, approval from a\n                            regional scientific ethical committee is not needed. Data collection\n                            from national registries was approved by the Regional Data Protection\n                            Agency (record no. 1-16-02-232-15). We ensure patient and public\n                            involvement in evaluating the acceptability of VISP by adopting an\n                            interviewing approach in the study.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                        <jats:title>Trial registration number<\/jats:title>\n                        <jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial \" xlink:href=\"NCT03395509\">NCT03395509<\/jats:ext-link>.<\/jats:p>\n                    <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-063335","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T11:49:14Z","timestamp":1683114554000},"page":"e063335","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Protocol for a cohort study to evaluate the effectiveness and\n                        cost-effectiveness of general population screening for cardiovascular\n                        disease: the Viborg Screening Programme (VISP)"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct03395509","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7525-9007","authenticated-orcid":false,"given":"Annette","family":"H\u00f8gh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes Sanddal","family":"Lindholt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rikke","family":"S\u00f8gaard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Refsgaard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorte","family":"Svenstrup","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels-J\u00f8rgen","family":"Moeslund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mette","family":"Bredsgaard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3814-1709","authenticated-orcid":false,"given":"Marie","family":"Dahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"2023050303465529000_13.2.e063335.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab892"},{"key":"2023050303465529000_13.2.e063335.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw334"},{"key":"2023050303465529000_13.2.e063335.3","unstructured":"CVD statistics 2017 2017."},{"key":"2023050303465529000_13.2.e063335.4","unstructured":"Eurostat . Population structure and ageing -\n                            statistics explained: eurostat (online data code:demo_pjanind).\n                            Available:\n                            https:\/\/ec.europa.eu\/eurostat\/statistics-explained\/index.php?title=Population_structure_and_ageing\n                            [Accessed 16 Feb 2022]."},{"key":"2023050303465529000_13.2.e063335.5","unstructured":"World Health Organization . Data and statistics.\n                            2022. Available:\n                            https:\/\/www-euro-who-int.ez-vks.statsbiblioteket.dk:12048\/en\/health-topics\/noncommunicable-diseases\/cardiovascular-diseases\/data-and-statistics\n                            [Accessed 16 Feb 2022]."},{"key":"2023050303465529000_13.2.e063335.6","doi-asserted-by":"crossref","unstructured":"Diederichsen ACP , Rasmussen LM , S\u00f8gaard R , et al .\n                            The Danish cardiovascular screening trial (DANCAVAS): study protocol for\n                            a randomized controlled trial. Trials 2015;16:554.\n                            doi:10.1186\/s13063-015-1082-6","DOI":"10.1186\/s13063-015-1082-6"},{"key":"2023050303465529000_13.2.e063335.7","doi-asserted-by":"crossref","unstructured":"Gr\u00f8ndal N , S\u00f8gaard R , Henneberg EW , et al . The\n                            Viborg vascular (VIVA) screening trial of 65-74 year old men in the\n                            central region of Denmark: study protocol. Trials 2010;11:67.\n                            doi:10.1186\/1745-6215-11-67","DOI":"10.1186\/1745-6215-11-67"},{"key":"2023050303465529000_13.2.e063335.8","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1002\/bjs.10872","article-title":"Cost-Effectiveness of population-based vascular disease\n                            screening and intervention in men from the Viborg vascular (VIVA)\n                            trial","volume":"105","author":"S\u00f8gaard","year":"2018","journal-title":"Br J Surg"},{"key":"2023050303465529000_13.2.e063335.9","doi-asserted-by":"crossref","first-page":"2256","DOI":"10.1016\/S0140-6736(17)32250-X","article-title":"Population screening and intervention for vascular disease in\n                            danish men (VIVA): a randomised controlled trial","volume":"390","author":"Lindholt","year":"2017","journal-title":"Lancet"},{"key":"2023050303465529000_13.2.e063335.10","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1002\/bjs.11135","article-title":"Baseline findings of the population-based, randomized,\n                            multifaceted Danish cardiovascular screening trial (DANCAVAS) of men\n                            aged 65-74 years","volume":"106","author":"Lindholt","year":"2019","journal-title":"Br J Surg"},{"key":"2023050303465529000_13.2.e063335.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2009.10.001"},{"key":"2023050303465529000_13.2.e063335.12","doi-asserted-by":"crossref","unstructured":"Gepner AD , Young R , Delaney JA , et al . Comparison\n                            of coronary artery calcium presence, carotid plaque presence, and\n                            carotid intima-media thickness for cardiovascular disease prediction in\n                            the multi-ethnic study of atherosclerosis. Circ Cardiovasc Imaging\n                            2015;8:e002262.\n                            doi:10.1161\/CIRCIMAGING.114.002262","DOI":"10.1161\/CIRCIMAGING.114.002262"},{"key":"2023050303465529000_13.2.e063335.13","doi-asserted-by":"crossref","unstructured":"Dahl M , Frost L , S\u00f8gaard R , et al . A\n                            population-based screening study for cardiovascular diseases and\n                            diabetes in Danish postmenopausal women: acceptability and prevalence.\n                            BMC Cardiovasc Disord 2018;18:20.\n                            doi:10.1186\/s12872-018-0758-8","DOI":"10.1186\/s12872-018-0758-8"},{"key":"2023050303465529000_13.2.e063335.14","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1093\/ehjci\/jex239","article-title":"Carotid plaque thickness and carotid plaque burden predict\n                            future cardiovascular events in asymptomatic adult\n                            Americans","volume":"19","author":"Sillesen","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023050303465529000_13.2.e063335.15","doi-asserted-by":"publisher","DOI":"10.1191\/1358863x06vm666ra"},{"key":"2023050303465529000_13.2.e063335.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.01.017"},{"key":"2023050303465529000_13.2.e063335.17","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"2023050303465529000_13.2.e063335.18","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X07084911"},{"key":"2023050303465529000_13.2.e063335.19","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s40258-017-0310-5","article-title":"EQ-5D and the euroqol group: past, present and\n                            future","volume":"15","author":"Devlin","year":"2017","journal-title":"Appl Health Econ Health Policy"},{"key":"2023050303465529000_13.2.e063335.20","unstructured":"Who . Use of glycated haemoglobin (HbA1c) in the\n                            diagnosis of diabetes mellitus abbreviated report of a WHO consultation\n                            2011."},{"key":"2023050303465529000_13.2.e063335.21","doi-asserted-by":"crossref","unstructured":"Harvey LA . REDCap: web-based software for all types\n                            of data storage and collection. Spinal Cord 2018;56:625.\n                            doi:10.1038\/s41393-018-0169-9","DOI":"10.1038\/s41393-018-0169-9"},{"key":"2023050303465529000_13.2.e063335.22","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811399958"},{"key":"2023050303465529000_13.2.e063335.23","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"2023050303465529000_13.2.e063335.24","unstructured":"Committee NM-S . NOMESCO classification of surgical\n                            procedures S (NCSP). 2009."},{"key":"2023050303465529000_13.2.e063335.25","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.ejvs.2016.12.031","article-title":"Validity of peripheral arterial disease diagnoses in the\n                            danish national patient registry","volume":"53","author":"Lasota","year":"2017","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2023050303465529000_13.2.e063335.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2003.11.011"},{"key":"2023050303465529000_13.2.e063335.27","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/bcpt.12610","article-title":"Validity of the prescriber information in the Danish national\n                            prescription registry","volume":"119","author":"Rasmussen","year":"2016","journal-title":"Basic Clin Pharmacol Toxicol"},{"key":"2023050303465529000_13.2.e063335.28","doi-asserted-by":"crossref","first-page":"273","DOI":"10.2147\/CLEP.S13458","article-title":"Existing data sources for clinical epidemiology: Aarhus\n                            university prescription database","volume":"2","author":"Ehrenstein","year":"2010","journal-title":"Clin Epidemiol"},{"key":"2023050303465529000_13.2.e063335.29","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394715"},{"key":"2023050303465529000_13.2.e063335.30","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811408483"},{"key":"2023050303465529000_13.2.e063335.31","unstructured":"S\u00f8rensen Henrik Toft CTSHKPL . Use of medical\n                            databases in clinical epidemiology. Aarhus university,\n                            2009."},{"key":"2023050303465529000_13.2.e063335.32","unstructured":"Patton Q . Qualitative evaluation and research\n                            methods. 2nd edn. Thousand oaks: Saga Publikations,\n                            1990."},{"key":"2023050303465529000_13.2.e063335.33","unstructured":"Kvale S . Interview: det kvalitative\n                            forskningsinterview som h\u00e5ndv\u00e6rk. 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