A Cost-Effectiveness Analysis of Lung Cancer Screening With Low-Dose Computed Tomography and a Diagnostic Biomarker.
A Cost-Effectiveness Analysis of Lung Cancer Screening With Low-Dose Computed Tomography and a Diagnostic Biomarker.
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DOI：
10.1093/jncics/pkab081
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发表时间：
2021-12
影响因子：
4.4
通讯作者：
Plevritis SK
中科院分区：
文献类型：
--
作者：
Toumazis I;Erdogan SA;Bastani M;Leung A;Plevritis SK
The Lung Computed Tomography Screening Reporting and Data System (Lung-RADS) reduces the false-positive rate of lung cancer screening but introduces prolonged periods of uncertainty for indeterminate findings. We assess the cost-effectiveness of a screening program that assesses indeterminate findings earlier via a hypothetical diagnostic biomarker introduced in place of Lung-RADS 3 and 4A guidelines. We evaluated the performance of the US Preventive Services Task Force (USPSTF) recommendations on lung cancer screening with and without a hypothetical noninvasive diagnostic biomarker using a validated microsimulation model. The diagnostic biomarker assesses the malignancy of indeterminate nodules, replacing Lung-RADS 3 and 4A guidelines, and is characterized by a varying sensitivity profile that depends on nodules' size, specificity, and cost. We tested the robustness of our findings through univariate sensitivity analyses. A lung cancer screening program per the USPSTF guidelines that incorporates a diagnostic biomarker with at least medium sensitivity profile and 90% specificity, that costs $250 or less, is cost-effective with an incremental cost-effectiveness ratio lower than $100 000 per quality-adjusted life year, and improves lung cancer-specific mortality reduction while requiring fewer screening exams than the USPSTF guidelines with Lung-RADS. A screening program with a biomarker costing $750 or more is not cost-effective. The health benefits accrued and costs associated with the screening program are sensitive to the disutility of indeterminate findings and specificity of the biomarker, respectively. Lung cancer screening that incorporates a diagnostic biomarker, in place of Lung-RADS 3 and 4A guidelines, could improve the cost-effectiveness of the screening program and warrants further investigation.
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影响因子：
6.2
作者：
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通讯作者：
Gatsonis, Constantine
影响因子：
4.5
作者：
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通讯作者：
McMahon, Pamela M.
影响因子：
10.3
作者：
Ajona, Daniel;Pajares, Maria J.;Pio, Ruben
通讯作者：
Pio, Ruben
影响因子：
--
作者：
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通讯作者：
Pio R
DOI：
10.1097/jto.0b013e31822e59b3
发表时间：
2011-11
期刊：
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
影响因子：
--
作者：
McMahon PM;Kong CY;Bouzan C;Weinstein MC;Cipriano LE;Tramontano AC;Johnson BE;Weeks JC;Gazelle GS
通讯作者：
Gazelle GS