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Figure 2 Impact of prevalence of low ejection fraction (EF) (<40%) on the cost-effectiveness (C-E) of screening for men and women using B-type natriuretic peptide (BNP) followed by echocardiography in those with a positive test. The cost-effectiveness ratio drops below $100,000 per quality-adjusted life year (QALY) gained at a prevalence over 0.5% and drops below $50,000 at a prevalence over 1%. For any given prevalence of disease the cost-effectiveness ratio is lower for women because the accuracy of BNP is slightly greater for women then men (9). Open circles = men (BNP vs. no screen); closed circles = women (BNP vs. no screen). LV = left ventricular.