Cost-effectiveness analysis of PET/CT surveillance imaging to detect systemic recurrence in resected stage III melanoma: study protocol
| Autor: | Mbathio Dieng, Sarah J. Lord, Omgo E. Nieweg, Rachael L. Morton, John F. Thompson, Mai Thi Hoang Nguyen, Robyn P. M. Saw, Jay Allen, Robin M. Turner, Alexander M. Menzies, Nikita Khanna |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Adolescent Cost-Benefit Analysis Disease risk management Health Economics PET/CT surveillance imaging Recurrence Positron Emission Tomography Computed Tomography Health care medicine Humans resected stage III melanoma Melanoma Neoplasm Staging Protocol (science) PET-CT Health economics Cost–benefit analysis medicine.diagnostic_test business.industry Cost-effectiveness analysis Australia General Medicine Positron emission tomography systemic recurrence Emergency medicine oncology Medicine radiology & imaging Neoplasm Recurrence Local business |
| Zdroj: | BMJ Open BMJ Open, Vol 10, Iss 11 (2020) |
| Popis: | IntroductionIn the new era of effective systemic therapies for advanced melanoma, early detection of lower volume recurrent disease using surveillance imaging can improve survival. However, intensive imaging follow-up strategies are likely to increase costs to health systems and may pose risks to patients. The objective of this study is to estimate from the Australian health system perspective the cost-effectiveness of four follow-up strategies in resected stage III melanoma over a 5-year period following surgical treatment with curative intent.Methods and analysisA decision-analytic model will be built to estimate the costs and benefits of (1) 12 monthly, (2) 6 monthly, (3) 3–4 monthly positron emission tomography/CT imaging for 5 years, compared with (4) no imaging follow-up. The model will be populated with probabilities of disease recurrence, test performance measures using data from >1000 consecutive resected stage III melanoma patients from Melanoma Institute Australia diagnosed between 2000 and 2017. Healthcare resource use, including surveillance imaging, doctor’s visits, subsequent tests and procedures to investigate suspicious findings, will be quantified from detailed patient records and valued using Australian reference pricing. Economic outcomes include cost per new distant melanoma recurrence detected and cost per diagnostic error avoided, for no imaging compared with the other strategies.Deterministic sensitivity analyses will examine the robustness of model results.Ethics and disseminationThis study was approved by the Sydney Local Health District, Sydney Local Health District Ethics Review Committee (RPAH Zone), AU/1/830638 and the Australian Institute of Health and Welfare (EO2019-1-454). The results of this study will be published in peer-reviewed medical and health economics journals and will inform melanoma management guidelines. |
| Databáze: | OpenAIRE |
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