Two view mammography at incident screens: cost effectiveness analysis of policy options
Two view mammography at incident screens: cost effectiveness analysis of policy options
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DOI：
10.1136/bmj.319.7217.1097
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发表时间：
1999-10-23
影响因子：
--
通讯作者：
Brown, J
中科院分区：
文献类型：
--
作者：
Johnston, K;Brown, J
目的确定两个视图乳腺X线摄影在事件屏幕的成本效益设计增量成本效益分析认识到当前阅读政策的差异，基于有效性数据从一项观察性研究设置在英格兰和威尔士的乳腺筛查计划主要结果措施健康服务成本，癌症检测，增量成本效益比每癌症检测，结果对于目前使用一个视图与某种形式的双重阅读的方案，两个视图乳腺X射线摄影艺术事件屏幕的增量成本效益比范围在6589磅和6716磅之间，取决于阅读政策。对于目前使用单视图单阅读的方案，发现两种政策选择比双视图单阅读更有效：单视图双阅读（仲裁; 210磅的增量成本效益比）和双视图双阅读（仲裁）。采用单次阅读的单视图的Tf程序改为双次阅读（仲裁），然后改为双视图双次阅读（仲裁），可以检测到额外的癌症，增量成本效益比为7983磅。在英格兰和威尔士的方案中，在事件屏幕上的两个视图的乳房X射线摄影的实施成本将是290万磅，将需要13.4个全职等效radiologist.Conclusions的成本效益的两个视图的乳房X射线摄影在事件屏幕取决于电影阅读政策。在英格兰和威尔士，只有当使用单阅读的程序改为双阅读时，在事故屏幕上进行双视图乳房X光检查的政策才会有效。鉴于资源有限，应优先考虑在目前使用单次阅读的程序子集中引入双次阅读，因为这需要较少的额外放射科医生，并且更具成本效益。
Objective To determine the cost effectiveness of two view mammography at incident screens.Design Incremental cost effectiveness analyses recognising differences in current reading policy, based on effectiveness data from an observational study.Setting Breast screening programmes in England and Wales.Main outcome measures Health service costs, cancers detected, incremental cost effectiveness ratios per cancer detected, whole time equivalent staff.Results For programmes currently using one view with some form of double reading, the incremental cost effectiveness ratio of two view mammography art incident screens ranged between pound 6589 and pound 6716, depending on the reading policy. For programmes currently using one view with single reading, two policy options were found to be more efficient than two view single reading: one view with double reading (arbitration; incremental cost effectiveness ratio of pound 210) and two view double reading (arbitration). Tf programmes using one view with single reading changed to double reading (arbitration) and then subsequently to two views double reading (arbitration), additional cancers could be detected with an incremental cost effectiveness ratio of pound 7983. The implementation cost of two view mammography at incident screens in programmes in England and Wales would be pound 2.9 million and would require 13.4 whole time equivalent radiologists.Conclusions The cost effectiveness of two view mammography at incident screens depends on the film reading policy. A policy of two view mammography at incident screens in England and Wales would be efficient only if programmes using single reading moved to double reading. Given limited resources, priority should be given to introducing double reading in the subset of programmes currently using single reading as this requires fewer additional radiologists and is more cost effective.