Protocol for the economic evaluation of the China Salt Substitute and Stroke Study (SSaSS)

Ka Chun Li*, Maoyi Tian, Bruce Neal, Liping Huang, Jie Yu, Yishu Liu, Xuejun Yin, Xinyi Zhang, Yangfeng Wu, Nicole Li, Paul Elliott, Lijing Yan, Darwin Labarthe, Zhixin Hao, Jingpu Shi, Xiangxian Feng, Jianxin Zhang, Yuhong Zhang, Ruijuan Zhang, Bo ZhouZhifang Li, Jixin Sun, Yi Zhao, Yan Yu, Lei Si, Thomas Lung

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction Cardiovascular diseases (CVDs) are the leading causes of death and disability worldwide. Reducing dietary salt consumption is a potentially cost-effective way to reduce blood pressure and the burden of CVD. To date, economic evidence has focused on sodium reduction in food industry or processed food with blood pressure as the primary outcome. This study protocol describes the planned within-trial economic evaluation of a low-sodium salt substitute intervention designed to reduce the risk of stroke in China. Methods and analyses The economic evaluation will be conducted alongside the Salt Substitute and Stroke Study: a 5-year large scale, cluster randomised controlled trial. The outcomes of interest are quality of life measured using the EuroQol-5-Dimensions and major adverse cardiovascular events. Costs will be estimated from a healthcare system perspective and will be sought from the routinely collected data available within the New Rural Cooperative Medical Scheme. Cost-effectiveness and cost-utility analyses will be conducted, resulting in the incremental cost-effectiveness ratio expressed as cost per cardiovascular event averted and cost per quality-adjusted life year gained, respectively. Ethics and dissemination The trial received ethics approval from the University of Sydney Ethics Committee (2013/888) and Peking University Institutional Review Board (IRB00001052-13069). Informed consent was obtained from each study participant. Findings of the economic evaluation will be published in a peer-reviewed journal and presented at international conferences. Trial registration number Registry (NCT02092090).

Original languageEnglish (US)
Article numbere045929
JournalBMJ open
Issue number7
StatePublished - Jul 20 2021


  • cardiac epidemiology
  • health economics
  • nutrition & dietetics
  • public health
  • stroke medicine

ASJC Scopus subject areas

  • Medicine(all)


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