Further Development of the Program on Preventive Health Check-Ups

Research area: Prevention and screening

Part 1:

Duration: Mid-April 2025 – Mid-November 2025 (7 PM)
Language: English (with German summary)

Part 2: 
Duration: May 2025 – August 2025 (2 PM)
Language: English with German summary

Background:
According to the Federation of Social Insurances in Austria, preventive medical check-ups (PMC; short-term: health check-up) have significantly contributed to the increased life expectancy in Austria since 1974 [15]. In the national context, preventive check-up aims to reduce health risk factors (primary prevention) and enable early disease detection (secondary prevention). A particular focus is placed on cardiovascular diseases and cancer, which are among the most common causes of death in Austria [16]. To sustainably improve the population's overall health, the program is available to all individuals aged 18 and over with a primary residence in Austria [15]. These examinations are primarily conducted by general practitioners and specialists in internal medicine [15]. Depending on age and sex, specific health topics are addressed, including risk assessment for cardiovascular disease (CVD) and lifestyle-related counselling and support [17]. The two-stage preventive process begins with identifying risk factors through blood tests, urine analysis, and physical examinations, followed by a discussion of findings and (lifestyle-related) counselling.

Part 1: Reviews on lifestyle counselling and scores for the prognosis of cardiovascular diseases

Project lead: Jule Anna Pleyer
Project team: Jule A. Pleyer, Lena Grabenhofer, Viktoria Hofer
Internal review: Ingrid Zechmeister- Koss
Duration: Mid-April 2025 until Mid-November 2025 (7 PM)
Language: English (with German summary)

Part 1 focuses on two key areas of the preventive medical check-up: lifestyle counselling (LsC) as a primary prevention measure and risk assessment scores for CVD as part of secondary prevention. Separate reports are provided for each of these aspects.

Report 7.1.1: Brief interventions for lifestyle counselling: Systematic Review

First author: Jule Anna Pleyer
Second author: Lena Grabenhofer

Background:
An unhealthy lifestyle is closely linked to the burden of disease in Austria, where two-thirds of the population is affected by chronic illnesses and health problems [18]. According to the Austrian Health Report 2022, women spend an average of 19.5 years and men 16.4 life years in moderate to poor health. This is mainly due to musculoskeletal disorders, diabetes, asthma, COPD, cancer, cardiovascular diseases, and depression [18]. The development of these chronic conditions is primarily associated with four major risk factors: tobacco use, unhealthy diet, physical inactivity, and excessive alcohol consumption [19].

In 2018, the Austrian Federation of Social Insurances revised the Austrian preventive medical check-up (short-term: health check-up) in collaboration with the Austrian Medical Association [20]. A key outcome of this revision was the significant enhancement of the physician's role as a counsellor. Doctors are now expected to increasingly consider patients' life circumstances and offer tailored counselling on smoking cessation, nutrition, and physical activity. As an integral part of the Austrian preventive medical check-up, lifestyle counselling (LsC) can potentially prevent specific diseases and improve public health more broadly, serving preventive and health-promoting purposes [21].

The guideline for the preventive medical check-up [20]outlines specific interventions when certain thresholds are exceeded (e.g. nutritional counselling in cases of elevated BMI) and recommends a structured approach to addressing alcohol and tobacco use through the "five Es" framework: Enquire, Evaluate, Elicit, Encourage, and Enable. Moreover, the 2016 Austrian health reform introduced a national strategy to improve communication quality in healthcare. This includes communication tools to support healthcare professionals in counselling, as high-quality, patient-centred communication has been shown to positively impact health behaviour [22].

Despite the availability of preventive medical check-up guidelines and communication tools, Austria's dietary and physical activity patterns have worsened in recent years. Tobacco use among men and alcohol consumption in general remain at the EU average, while tobacco use among women is even above average. Furthermore, every second person in Austria demonstrates limited health literacy [18]. These developments highlight the need to examine the extent to which lifestyle counselling contributes to improving population health in Austria and how practitioners can be better supported in delivering effective counselling.

Objectives:
The main objective of Report 1 is to systematically identify lifestyle-related brief interventions on physical activity, healthy diet and alcohol consumption, to comparatively analyse their effectiveness and exploratively investigate their feasibility for implementation in Austrian preventive medical check-ups. This will help to develop evidence-based recommendations for improving the Austrian health check-ups. 

The following research questions (RQs) arise from this aim:

1.     RQ1: What evidence-based brief interventions (e.g. communication models, practical tools) are used in lifestyle counselling for physical activity, healthy diet, and alcohol consumption?

2.     RQ2: How effective are the identified interventions and their specific characteristics (e.g. trained intervention) in comparison to each other in improving lifestyle change among recipients.

3.     RQ3: What are the implementation requirements and barriers for lifestyle-related brief interventions within the Austrian preventive medical check-up?

Non-objective:
This report does not aim to create a practice handbook for implementing LsC.

Methods:
Research questions 1 and 2:
To address the first two research questions regarding the identification of lifestyle-related brief interventions for physical activity, healthy diet, and alcohol consumption, as well as a comparison of their effectiveness, we will conduct a systematic literature search in multiple databases for reviews (and primary studies, if reviews are unavailable). Relevant literature will be identified based on pre-defined inclusion and exclusion criteria. Existing brief lifestyle interventions for counselling (tools, communication forms, psychological models, information material) will be extracted from the relevant literature, summarised in pre-structured tables, and narratively synthesised. No quality assessment will be performed for Research Question 1 (RQ1). To answer Research Question 2 (RQ2), the quality of the selected literature will be assessed using appropriate instruments (depending on the study design).

All steps involved in answering the two research questions (literature selection, quality assessment, data extraction, and synthesis) will be carried out using the four-eyes principle by the two authors (JP, LMG, and possibly VH).

Research Question 3:
Qualitative expert interviews will be conducted to answer the third research question. Practitioners who already carry out preventive medical check-ups will be interviewed using semi-structured interview guides. The interviews will focus on the current challenges and needs encountered by the respondents during the implementation of LsC as well as an assessment of facilitators and the feasibility of identified tools and approaches in practice. The interviews will be transcribed and analysed using qualitative content analysis.

PICO LsC:

Population	Recipients of lifestyle-related brief interventions in counselling settings. Keywords: brief intervention; lifestyle counselling; behaviour change; obesity; nutrition; healthy diet; physical activity; alcohol; check-up; primary care
Intervention	Brief Interventions (measures, programs, tools, communication guidelines) for Lifestyle Counselling on: Physical activity (PA) Healthy diet (HD) Alcohol consumption (AC)
Comparison	Comparison of brief interventions and/or their parameters against each other (or against Standard of care, if reviews comparing interventions are unavailable)
Outcomes	Research Question 1: Lifestyle-related brief interventions on PA, HD, and AC Characteristics of the brief interventions Research Question 2: Comparative effectiveness of lifestyle-related brief interventions on physical activity, healthy diet and alcohol consumption e.g. in relation to, but not limited to: - Behavioural changes of the recipients (e.g. food intake, physical activities/daily movement, consumption free days etc.) - Improvement of parameters indicating risk reduction (e.g. blood sugar, cholesterol, nutrients, BMI, etc.) - Improvement in (e.g. nutrition-related) quality of life and emotional well-being Research Question 3: Current challenges and needs in the implementation of LsC Applicability of identified brief interventions
Study design	Research Questions 1 and 2: Reviews (primary studies, if reviews are unavailable) Research Question 3: Semi-structured expert interviews with physicians (n=~5), who conduct health check-ups in practice and qualitative content analysis (Example questions: What would make the implementation in practice easier? Imagine you have the following tools (identified evidence-based tools from the literature) – how do you envision their practical application?)
Countries	Western countries with comparable healthcare systems
Languages	Research Questions 1 and 2: English, German Research Question 3: German

Report 7.1.2: Scores for Cardiovascular Diseases (CVD)

First author: Lena Grabenhofer
Second author: Jule Anna Pleyer

Background:
Cardiovascular diseases (CVD) are among the most common non-communicable diseases and causes of death worldwide [23, 24]. The forecast for the coming years is particularly concerning: whilst approximately 17.3 million people currently die annually from the consequences of CVD (as of 2018), despite continuous advances in cardiology, an increase to around 23.6 million deaths is projected by 2030. This development primarily affects Western societies [25]. In Austria, this global issue is reflected in concrete figures: 31,129 persons died from the consequences of CVD in 2023, with 22,510 of these deaths affecting people aged 80 years and older [26].

A complex interplay of various risk factors facilitates the development of CVD. These can be categorised as follows [9]:

• Physical factors (e.g., genetic predisposition, hyperglycaemia, overweight, obesity, diabetes)
• Behavioural factors (e.g., smoking, poor nutrition, lack of exercise)
• Psychological factors (e.g., chronic stress, personality factors)
• Social factors (e.g., education, income, occupational position)

In addition to causing an enormous disease burden, CVD also incurs high costs for the healthcare system. The annual costs due to CVD in the EU are estimated at around €282 billion. Of this, approximately €155 billion (55%) is attributable to direct healthcare costs and long-term care, a further €48 billion (17%) arises from productivity losses. The remaining €79 billion (28%) are attributed to costs incurred through the time and effort of informal caregivers [27].

Through appropriate preventive measures, premature deaths due to CVD and early development of CVD can be delayed, thereby improving healthy life expectancy. The prevention of CVD is a multi-faceted concept that operates on several levels:

Primary prevention: Avoidance and reduction of known risk factors. The promotion of a healthy lifestyle is paramount here before any disease occurs.

Secondary prevention: Early detection of diseases and risks.

Tertiary prevention: Prevention of the progression of existing diseases and possible consequential illnesses [28].

Against this background, the importance of a systematic risk assessment (secondary prevention) for CVD will be examined. In addition to family history, existing diabetes mellitus and smoking status, the most important examination parameters include findings on blood pressure, total and HDL (high-density lipoprotein) cholesterol [20]. Modern scoring models such as SCORE-2, PROCAM, and Arriba (developed from the Framingham Risk Score) enable a prediction of the individualised 10-year overall risk for fatal and non-fatal cardiovascular events [29]. For example, the European Society of Cardiology (ESC) introduced a revised version of the SCORE risk assessment in its 2021 guidelines for preventing cardiovascular diseases, the SCORE2. Additionally, the SCORE2-OP (for "older persons") was developed for the specific risk assessment in people over 70 years of age, which takes into account the particular risk factors of this age group [30].

Objectives:
The second report aims to systematically capture the scientific literature on the possibilities of predicting cardiovascular diseases, compare the most frequently described risk prediction models applicable to the Western European population, and evaluate them regarding their implementation possibilities within the framework of preventive health check-ups. Consideration should be given to which (additional) prerequisites must be fulfilled for the implementation of the respective instruments and how the results of the risk scores affect further health-related examinations. The focus here is on the uniform implementation of the scoring models in Austria.

This gives rise to the following research questions:

1. RQ1: How do cardiovascular risk prediction models (e.g., ARRIBA, SCORE2, SCORE2-OP and SCORE2-Diabetes) compare, and how do they differ in terms of their evidence, predictive validity, benefit-harm balance and their implementability within the framework of Austrian preventive health check-ups?
2. RQ2: To what extent does the application of cardiovascular risk prediction models lead to long-term health benefits, as well as to changes in the health behaviour of patients?
3. RQ3: Which parameters are already standardly collected in preventive health check-ups, which additional examinations are required for an optimal implementation of the risk scores, and which organisational, time and personnel resources are needed for this?

Non-Objectives:
The project does NOT aim to provide a quantitative budget impact analysis for RQ3

Methods:
To answer the research questions RQ1 to RQ3, a systematic literature review will first be conducted. The selection of relevant publications is based on pre-defined inclusion and exclusion criteria. All methodological steps, including literature selection, data extraction and, if necessary, quality assessment, are carried out according to the four-eyes principle: one scientist undertakes the primary processing, whilst a second scientist reviews and validates these results. After completing the literature review, the identified outcomes are systematically extracted and narratively summarised.

Based on this, the most important instruments for cardiovascular risk prediction in the Western European region, including SCORE2, SCORE2-OP, SCORE2-Diabetes as well as PROCAM and ARRIBA, are to be identified and compared. The analysis is structured into several consecutive steps:

First, a comprehensive inventory of existing prognostic instruments and their methodological foundations is conducted.

In the second step, the evidence base of these instruments is critically examined. The central question here is to what extent the prognostic scores can precisely predict the actual cardiovascular risk and whether their application demonstrably leads to measurable health improvements.

The third research focus in the data analysis lies on the practical implementation aspects: which specific parameters are needed for the various scores, which of these are already standardly collected in preventive health check-ups in Austria, and what additional effort is created for patients and medical personnel.

PICO 2 CVD:

Population	Addressees of cardiovascular risk prediction (patients) Keywords: Arriba, SCORE2, Procam, cardiovascular risk prediction, cardiovascular disease, cardiovascular disease, screening, ARRIBA score, Framingham Risk Score
Intervention	Risk prediction models for cardiovascular diseases (e.g. SCORE2, PROCAM, Arriba score)
Comparison	Comparison of the various risk models with each other and, if necessary, with standard care without structured risk assessment. Current prevention programme without extended risk scores.
Outcomes	Predictive validity of the risk models Long-term effects on cardiovascular event rates and mortality Quality of life Practical feasibility Additional resources required (time, personnel, structures) Acceptance by physicians and patients
Study Design	High-quality systematic reviews or RCTs/primary studies All other outcomes: no restrictions in study design
Countries	Western Europe, Austria
Languages	English, German

Time table:

Time period	Tasks
April 2025	Scoping and finalisation of the project protocol
May 2025	Systematic Reviews Systematic literature search and manual searches Literature selection Primary data collection Development of interview guideline
June – July 2025	Systematic Reviews Data extraction and quality assessment Primary data collection Conduction interviews Data extraction
August – September 2025	Writing
October 2025	Internal and external Review
November 2025	Layout & Publication

References:
[1]  Langmann H. e. a. Bericht des Dachverbandes der Sozialversicherungsträger an das Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz gemäß § 447h (4) ASVG für das Jahr 2023. 2024.
[2]  Gesundheit.gv.at. Die Vorsorgeuntersuchung auf einen Blick. 2025 [updated 27. 04  2021; cited 10.04.2025].
[3]  Sozialversicherungen Ö. Vorsorgeuntersuchung. 2020.
[4]  Bundesministerium für Soziales G., Pflege und Konsumentenschutz (BMSGPK). Österreichischer Gesundheitsbericht 2022. Wien: 2023.
[5]  CDC. About Chronic Diseases. 2024 [cited 11.04.2025]. Available from: https://www.cdc.gov/chronic-disease/about/index.html#:~:text=Most%20chronic%20diseases%20are%20caused,ability%20to%20make%20healthy%20choices.
[6]  Vorsorgeuntersuchung. 2018 [cited 11.04.2025]. Available from: https://www.sozialversicherung.at/cdscontent/load?contentid=10008.605059&version=1540894684&utm_source=chatgpt.com.
[7]  Tiemann M. M., Melvin Prävention und Gesundheitsförderung. Berlin: Springer-Verlag GmbH; 2021.
[8]  GmbH G. Ö. ÖPGK?Toolbox Gesundheitskompetenz. Maßnahmen zur Förderung der Gesundheitskompetenz der österreichischen Bevölkerung. Vienna, Austria: 2023.
[9]  Griebler R. W., Petra; Delcour, Jennifer; Eisenmann, Alexander. Herz-Kreislauf-Erkrankungen in Österreich Update 2020. Wien: 2021  [cited 09.04.2025]. Available from: https://www.sozialministerium.at/dam/jcr:ef1ec0fd-01a7-4047-9828-42ce906a2239/Bericht__HKE_2020_2021_Mit_Titelbild.pdf.
[10]  Visseren F. L. J., Mach F., Smulders Y. M., Carballo D., Koskinas K. C., Back M., et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227-3337. DOI: 10.1093/eurheartj/ehab484.
[11]  Bundesministerium Arbeit S., Gesundheit, Pflege und Konsumentenschutz Herz-Kreislauf-Krankheiten. [updated 13.12.2021; cited 09.04.2024]. .
[12]  AUSTRIA S. Häufigste Todesursachen 2023 weiterhin HerzKreislauf-Erkrankungen und Krebs. Pressemitteilung: 13 366-132/24 ed. Wien: Bundesanstalt Statistik Österreich; 2024.
[13]  Luengo-Fernandez R., Walli-Attaei M., Gray A., Torbica A., Maggioni A. P., Huculeci R., et al. Economic burden of cardiovascular diseases in the European Union: a population-based cost study. Eur Heart J. 2023;44(45):4752-4767. DOI: 10.1093/eurheartj/ehad583.
[14]  Gesundheit.gv.at. Herz-Kreislauf-Erkrankungen: Vorbeugung. 2021 [cited 09.04.2025]. .
[15]  Angelow A., Klötzer C., Donner-Banzhoff N., Haasenritter J., Schmidt C. O., Dörr M., et al. Validation of Cardiovascular Risk Prediction by the Arriba Instrument. Dtsch Arztebl Int. 2022;119(27-28):476-482. DOI: 10.3238/arztebl.m2022.0220.
[16]  group S. w. and collaboration E. S. C. C. r. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;42(25):2439-2454. DOI: 10.1093/eurheartj/ehab309.

Part 2: Rapid assessment on screening for chronic kidney disease and short summaries on prostate cancer screening, lung cancer screening and screening for abdominal aortic aneurysm  

Project lead: Doris Giess
Project team: Doris Giess, Julia Mayer-Ferbas
Internal review: Ingrid Zechmeister- Koss
Duration: May 2025 to August 2025 (2 PM)
Language: English with German summary

The focus of this part is on screening examinations that are not currently integrated into the Austrian health care system, namely screening for prostate cancer, lung cancer, abdominal aortic aneurysm (AAA) and chronic kidney disease (CKD).

Prostate cancer is the most common malignancy among men in Austria and represents one of the leading causes of cancer-related mortality. According to Statistics Austria, approximately 6,000 new cases of prostate cancer were diagnosed in 2022, corresponding to an age-standardised incidence rate of approximately 110 per 100,000 men [1]. 

The prostate-specific antigen (PSA) test has been utilised as a screening method since the 1990s. However, the benefits and potential harms associated with its population-wide application remain a subject of ongoing debate. 

According to Statistics Austria, around 4,600 new cases of lung cancer were diagnosed in 2021, corresponding to an age-standardised incidence rate of around 50 per 100,000 individuals [3]. Heavy smokers and former smokers are particularly at risk. For early detection, screening using low-dose CT (LDCT) is recommended or already implemented in several countries, as large, randomised studies have demonstrated a significant reduction in lung cancer-related mortality through this method [2-4]. 

AAA is a potentially life-threatening condition characterised by a pathological dilation of the abdominal aorta. Current data on the prevalence of AAA in Austria are limited. However, a recent global systematic review reports that the prevalence of AAA with a diameter ? 3.0 cm, ranges from 3.5% to 6.5% in men over 65 years of age. In women, the prevalence is significantly lower, ranging from 0.8% to 1.4% [5]. The overall mortality rate for patients with a ruptured abdominal aortic aneurysm (AAA) is approximately 75%, even with surgical intervention. If left untreated, rupture typically results in death within hours [6]. 

Early detection through ultrasound screening has been shown to significantly reduce the risk of rupture and increase survival rates [7]. 

Chronic kidney disease (CKD) is an escalating health concern worldwide. In Austria, approximately 8-10% of adults are affected by CKD, although the actual prevalence is likely higher due to the asymptomatic progression of the disease. Individuals with risk factors such as diabetes mellitus and hypertension are particularly susceptible. 

Early diagnosis and intervention are critical in slowing the progression of CKD and preventing complications, such as kidney failure. According to the Austrian Kidney Report, despite international recommendations advocating for the regular screening of at-risk populations, only around 17% of affected individuals in Austria are screened annually. While CKD screening in the general population is currently being investigated in various research studies, it is not yet implemented in most countries [8]. 

Project objectives: 
The objective of this report is to evaluate the evidence base for the respective screening strategies, drawing upon recent health technology assessment (HTA) reports and systematic reviews. The focus is primarily on the benefits for the relevant target populations. Furthermore, the current S3 guideline recommendations are summarised to provide an evidence-based foundation for decision-making within the Austrian screening context. 

Research Question 1:
How has the benefit of prostate cancer screening using prostate-specific antigen (PSA) been assessed in recent HTA reports in relation to patient-relevant outcomes, and what recommendations do current guidelines offer in this regard? 

Research Question 2:
How has the benefit of lung cancer screening using low-dose computed tomography (LDCT) been evaluated in recent HTA reports with respect to patient-relevant outcomes, and what are the recommendations provided by current guidelines? 

Research Question 3:
How has the benefit of abdominal aortic aneurysm (AAA) screening via ultrasound been assessed in recent HTA reports in relation to patient-relevant outcomes, and what are the corresponding recommendations from current guidelines? 

Research Question 4:

a)     How has the benefit of chronic kidney disease (CKD) screening been assessed in recent systematic reviews, with respect to patient-relevant outcomes? 

b)     For which target populations was CKD screening found to be beneficial according to these reviews? 

c)     What are the current guideline recommendations? 

Non-Objective:
This report is not intended to conduct a detailed systematic review of primary studies. Instead, the focus is on a structured synthesis of evidence from existing reviews. Diagnostic accuracy studies and cost-effectiveness analyses are not within the scope of this report. The primary focus is on patient-relevant outcomes, such as all-cause mortality and morbidity. 

Methods:

 

Research Questions 1-3:
A manual search will be conducted for recent guidelines. Additionally, a systematic search for HTA reports will be performed in the INAHTA database and on the websites of relevant HTA institutions. 

 

A visual abstract will be created for each topic, illustrating the key elements of the respective HTA reports and guidelines. This visual abstract will include: 

• Description of the screening strategy and target population 
• Efficacy assessment based on patient-relevant outcomes 
• Possible inclusion of results from cost-effectiveness analyses 
• Presentation of harms, such as false-positive/negative results and overdiagnosis 

Research Question 4a/b/c:
Rapid review of systematic reviews on screening for chronic kidney disease (CKD) 

PICO:

Population	Adult patients >18 years without diagnosed CKD
Intervention	Screening for CKD, based on eGFR(SCr), eGFR(cystC) and Proteinuria/Albuminuria/ACR testing (POCT dipstick or urinalysis)
Control	No Screening/Standard of care
Outcomes	Clinical endpoints such as all-cause mortality, CKD-specific mortality, morbidity (e.g., improvement of kidney function/ progression to dialysis),  Percentage of positive screening tests  Percentage of confirmed CKD-diagnoses at follow-up   Harms from screening (misdiagnoses, psychological burden, unnecessary further investigations)  Percentage of medication initiation  Not: cost-effectiveness, diagnostic accuracy
Study designs	FFa/b: High-quality systematic reviews  FFc: Manual search for recent guidelines, search for HTA reports in the INAHTA database and websites of HTA institutions
Geographical Area	Western countries with established healthcare systems (including Europe, USA, UK, Australia)
Language	German, English

References:
[1]  Statistik Austria. (2023). Krebserkrankungen. Zugriff am 24. April 2025, von Krebserkrankungen - STATISTIK AUSTRIA - Die Informationsmanager 
[2]  Field, J. K., deKoning, H., Oudkerk, M., Anwar, S., Mulshine, J., Pastorino, U., Eberhardt, W., & Prosch, H. (2019). Implementation of lung cancer screening in Europe: challenges and potential solutions: summary of a multidisciplinary roundtable discussion.?ESMO open,?4(5), e000577. https://doi.org/10.1136/esmoopen-2019-000577 
[3]  Jonas, D. E., Reuland, D. S., Reddy, S. M., Nagle, M., Clark, S. D., Weber, R. P., ... & Harris, R. P. (2021). Screening for lung cancer with low-dose computed tomography: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA, 325(10), 971–987. https://doi.org/10.1001/jama.2021.1117 
[4]  Oudkerk, M., Liu, S., Heuvelmans, M. A., Walter, J. E., & Field, J. K. (2021). Lung cancer LDCT screening and mortality reduction - evidence, pitfalls and future perspectives.?Nature reviews. Clinical oncology,?18(3), 135–151. https://doi.org/10.1038/s41571-020-00432-6 
[5]  Song P, He Y, Adeloye D, Zhu Y, Ye X, Yi Q, Rahimi K, Rudan I; Global Health Epidemiology Research Group (GHERG). The Global and Regional Prevalence of Abdominal Aortic Aneurysms: A Systematic Review and Modeling Analysis. Ann Surg. 2023 Jun 1;277(6):912-919. doi: 10.1097/SLA.0000000000005716. Epub 2022 Sep 30. PMID: 36177847; PMCID: PMC10174099. The Global and Regional Prevalence of Abdominal Aortic Aneurysms: A Systematic Review and Modeling Analysis - PMC 
[6]  WGKK. (2021). Bauchaortenaneurysma Screening – Aktionswoche 2021. Zugriff am 24. April 2025, von https://www.ots.at/presseaussendung/OTS_20191025_OTS0031 
[7]  Jeanmonod D, Yelamanchili VS, Jeanmonod R. Abdominal Aortic Aneurysm Rupture. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.?Available from: https://www.ncbi.nlm.nih.gov/books/NBK459176/ 
[8]  Ali, M. U., Fitzpatrick-Lewis, D., Kenny, M., Miller, J., Raina, P., & Sherifali, D. (2018).  A systematic review of short-term vs long-term effectiveness of one-time abdominal aortic aneurysm screening in men with ultrasound. Journal of Vascular Surgery. https://www.jvascsurg.org/article/S0741-5214(18)30891-7/fulltext Österreichische Gesellschaft für Nephrologie. (2023). Chronische Nierenerkrankungen in Österreich. Abgerufen am 24. April 2025, von https://www.oegn.at