解锁心血管健康检查的价值-附录

Appendix Appendix 1. Overview of CVHCs across the EU Table 1 Overview of CVHCs across the EU (PwC analysis, updated December 2025). Appendix 2. Methodology This report draws on a structured approach for evidence synthesis, combining a non-exhaustivesystematic literature review with targeted screening, grey literature assessment and thematic analysis toevaluate the most relevant clinical, economic and societal value associated with CVHCs. An overview ofthe methodological approach is outlined below. a.Approach to data search and analysis Population, Intervention, Comparison and Outcomes (PICO) framework The scope of the review was defined using an adapted PICO framework to ensure a structured andtransparent assessment of the value of CVHCs. Given the nature of the available evidence, theframework primarily focused on Population, Intervention and Outcomes, as explicit comparators are notconsistently reported across the literature. •Population:Adult population living in the European region (EU Member States and associatedcountries), assessed across healthcare settings.•Intervention:CVHC programmes, defined as interventions that include an initial structuredassessment designed to identify individuals at elevated risk of cardiovascular or cardiometabolicdisease through the measurement of multiple risk factors and to initiate appropriate follow-up activities.•Outcomes:Quantitative outcomes capturing the clinical, economic and societal value of CVHCs. Research questions Based on this framework, three overarching research questions were formulated: •Which health outcomes (e.g. risk factor modification, CVD events averted, cardiovascular mortality)are associated with CVHC programmes?•Which economic outcomes (including healthcare resource use, cost savings, cost-effectiveness andreturn on investment) are associated with CVHC programmes?•Which societal outcomes (e.g. productivity, equity and quality-adjusted life years gained) areassociated with CVHC programmes? Additionally, programme design and implementation characteristics were captured and described whererelevant to contextualise and interpret reported outcomes. Search terms Guided by the adapted PICO framework focusing on three elements, a non-exhaustive list of searchterms was developed to support a literature search in PubMed (Table 5). Literature search A comprehensive search strategy was employed, combining structured searches in PubMed with atargeted review of relevant Cochrane Reviews. In addition, targeted grey literature searches wereconducted, including government evaluations, programme and institutional websites, clinical and policyguidelines, and reference tracking of relevant studies. Results from all sources were then systematicallydocumented and mapped out using a PRISMA flow diagram. Evidence screening Each value‑evidence source was reviewed using a dual-reviewer process. Titles were screened first,with abstracts and full texts assessed where eligibility was unclear. All abstracts were available inEnglish; where full‑text publications were not available in English, screening was conducted usingautomated translations. Inclusion and exclusion criteria Eligibility criteria were defined to ensure a consistent and transparent selection of evidence relevant tothe objectives of the review and are summarised inTable 2. Table 2 Inclusion and exclusion criteria. Inclusion criteria (all must apply) •Studies reporting quantitative data (outcomes) related to a structured health check assessing multiple cardiometabolicparameters in the adult population, including biological risk factors and/or assessment of health behaviours, lifestyle factorsor relevant personal and family medical history.•Studies reporting data from the European region, including EU Member States and associated countries (UK, Norway,Switzerland).•Studies published between 2015 and 2025.•For systematic literature reviews, studies including data from at least one EU country. Exclusion criteria •Studies focused mostly or exclusively on non‑cardiovascular screening programmes (e.g. breast, cervical or prostatecancer screening).•Studies examining single preventive or therapeutic interventions only (e.g. cost‑effectiveness of statins, polypill or individualmedications) without a structured health check component.•Research protocols or editorials without reported outcome data. Evidence base identification The identification, screening and inclusion of evidence sources are summarised inTable 3. Table 3 PRISMA flow diagram of study selection.The diagram summarizes the identification, screening, eligibility assessment,and inclusion of studies in the review, with reasons for exclusion at each stage. The initial search of PubMed yielded 320 unique records, which were screened against the predefinedinclusion and exclusion criteria. In parallel, additional relevant studies were identified through targetedsearches of the grey literature and other sources. Following eligibility as