Structured Abstract

Contents

• 1. Introduction
• 2. Methods
  • Key Questions
  • Model Design
• 3. Results
  • KQ 1a What Is the Lifetime Net Benefit of Aspirin?
  • KQ 1b What Is the Net Benefit of Aspirin Over 20 Years?
  • KQ 1c What Is the Net Benefit of Aspirin Over 10 Years?
  • KQ 2 What Is the Marginal Net Benefit of Initiating Aspirin Now Versus Waiting 10 Years?
  • Deterministic (One-Way) Sensitivity Analyses (KQs 1a–c)
  • Probabilistic Sensitivity Analyses (KQs 1a–c)
• 4. Discussion
  • Comparison to 2009 USPSTF Findings
  • Comparison to Other Recent Analyses
  • Limitations
  • Conclusions and Future Research Needs
• References
• Appendix A
• Appendix B Model Technical Documentation
• Addendum

Acknowledgments: The authors acknowledge the following individuals for their contributions to this project: Robert McNellis, PA, MPH, at AHRQ; current and former members of the U.S. Preventive Services Task Force who contributed to topic deliberations; Evelyn P. Whitlock, MD, MPH, Janelle M. Guirguis-Blake, MD, Jessica Chubak, PhD, MBHL, Melissa L. Anderson, MS, Tracy Beil, MS, Diana S.M. Buist, PhD, MPH, Brittany U. Burda, MPH, Corinne V. Evans, MPP, Alisha Feightner, MPH, Aruna Kamineni, PhD, MPH, Elizabeth A. O'Connor, PhD, Maya G. Rowland, MPH, Caitlyn A. Senger, MPH,and Selvi B. Williams, MD, MPH, with the Kaiser Permanente Research Affiliates EPC; and Amy B. LaFrance, MPH, and Logan H. Stuck, MS, at the HealthPartners Institute for Education and Research.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, . Contract No. HHSA-290-2012-00015-4, Task Order No. 4. Prepared by: Kaiser Permanente Research Affiliates Evidence-based Practice Center²,

Suggested citation:

Dehmer SP, Maciosek MV, Flottemesch, TJ. Aspirin Use to Prevent Cardiovascular Disease and Cancer: A Decision Analysis. AHRQ Publication No. 15-05229-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2015.

This report is based on research conducted by the Kaiser Permanente Research Affiliates Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA-290-2012-00015-4, Task Order No. 4). The findings and conclusions in this document are those of the authors, who are responsible for its contents, and do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information (i.e., in the context of available resources and circumstances presented by individual patients).

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

1

540 Gaither Road Rockville, Maryland 20850; www​.ahrq.gov

2

Kaiser Permanente Center for Health Research, Portland, OR