Table 1

Summary of impacts assumed for interventions evaluated in retrieved studies and associated effect size estimates used to derive economic outcomes
Intervention Different effects of intervention used Effect estimates used within individual studies Source of effect estimate-trial type and principal* source
Pharmacological interventions Polypill Reduced absolute risk CVD −20% [15] Meta analysis [16]
Reduced relative risk of CVD RR=0.12 [17] for cardiovascular disease Estimate based on RCT evidence [2]
RR=0.29 for IHD and 0.4 for stroke (primary prevention) [18] Overview of RCTs [19]
RR=0.12 for CHD and RR=0.2 for stroke [20] Multiplicative effects [21,22]
Reduction in BP and cholesterol + reduced absolute risk (to account for effects of aspirin) 20% reduction in cholesterol+33% reduction in difference in BP between 115** and current + 20% reduction absolute risk CVD (to account for benefits aspirin) [23] Product of estimates from RCT estimates used for Cholesterol and BP. For Aspirin [16]
20% reduction in cholesterol+28% reduction in difference in BP between 115** and current + 18% reduction absolute risk CVD (to account for benefits aspirin) [24] Product of estimates from RCT estimates used for Cholesterol and BP. For Aspirin [16]
Treatment of “high“cholesterol Reduction in total serum cholesterol concentration −20% [15]) RCT [21]
−20% [23] RCT [21]
−22% [25]) RCT [26]
Reduction in relative risk of cardiovascular disease RR=0.84 [20] Heart Protection Study Group [21].
RR=0.95 [17] Meta analysis [27]
Treatment of “high” BP Reduction in relative risk of disease RR=0.82 [17] Overview of RCTs [28]
RR=0.66 for stroke, RR=0.72 for CHD [20] Overview of RCTS. [22]
Reduction in the difference between SBP & 115 mmHg −33% reduction [15] Overview of RCTs [19]
−33% reduction [23] RCT [29]
Blood pressure lowering 10 mmHg lowering of BP, yielding 40% RR reduction stroke and 14% reduction for coronary heart disease. [30]. Overview of randomised trials [19]
Tobacco control Mass media smoking Reduction in smoking prevalence −2% [24]) Observational. Friend and Levy. 2002 [31].
−1.5%[15] Review of observational data [31]
Price increase cigarettes Reduction smoking attributable death 5-15% [32] Review of observational data [33]
Nicotine replacement therapy (gum) Increased likelihood of cessation OR=1.66 [34] Systematic review [35]
Increase in percentage using NRT who quit 5% [24]
Community pharmacist smoking cessation Increase in proportion using cessation services who become long term quitters 14.3% continuous quit rate compared to 2.7 if usual care [36]. RCT [37]
Bupropion-smoking cessation Reduced relative risk of CVD RR=0.8 [17] Systematic review [38]
Mass media interventions Mass media, diet/cholesterol Reduced total serum cholesterol −2% [15] Cost effectiveness analysis [39]
−2% [23] Cost effectiveness analysis [39]
Mass media salt/reductions food Reduced total dietary salt intake −20% (range 10-30%) [24] Effect of salt on BP from meta analysis [40] Mass media effects not supported.
−15% [15] No reference for impact on salt intake, impact of salt reduction on BP from trial data [41]
Reduced CVD prevalence −4% [32] Review [14] and expert opinion
Combined mass media Relative risk of CVD RR=0.98 [17] Meta analysis [42]
Legislative Interventions Salt in bread-voluntary/other Reduced CVD relative risk RR=0.99 [17] No reference for impact of legislation, review of trials supports impact of salt on CVD [43]
Legislation on salt in food Reduction in total dietary salt intake 30% reduction [23] No reference for impact of legislation. Impact of salt on BP from observational data [44]
Reduced salt intake via legislation + education Reduced systolic BP −2 mmHg (1-4) mmHg [32] Review [14] and expert opinion
Reduction in the difference between actual SBP & 115 mmHg 33% reduction [15]

*Where multiple source citations provided the highest in hierarchy of evidence is shown.

**115 mmHg suggested as theoretical minimum risk level for systolic blood pressure by WHO.

Abbreviations: CAD, Coronary Artery Disease; CVD: Cardiovascular Disease; SBP, Systolic Blood pressure, NRT, Nicotine replacement Therapy, WHO, World Health Organisation.

(where available the source of effect estimates cited in each study has been shown).

Shroufi et al.

Shroufi et al. BMC Public Health 2013 13:285   doi:10.1186/1471-2458-13-285

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