Economic analysis of combined endoscopic and endobronchial ultrasound in the evaluation of patients with suspected non-small cell lung cancer.

Hdl Handle:
http://hdl.handle.net/10147/127525
Title:
Economic analysis of combined endoscopic and endobronchial ultrasound in the evaluation of patients with suspected non-small cell lung cancer.
Authors:
Harewood, Gavin C; Pascual, Jorge; Raimondo, Massimo; Woodward, Timothy; Johnson, Margaret; McComb, Barbara; Odell, John; Jamil, Laith H; Gill, Kanwar Rupinder S; Wallace, Michael B
Affiliation:
Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
Citation:
Economic analysis of combined endoscopic and endobronchial ultrasound in the evaluation of patients with suspected non-small cell lung cancer. 2010, 67 (3):366-71 Lung Cancer
Journal:
Lung cancer (Amsterdam, Netherlands)
Issue Date:
Mar-2010
URI:
http://hdl.handle.net/10147/127525
DOI:
10.1016/j.lungcan.2009.04.019
PubMed ID:
19473723
Additional Links:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2822087/?tool=pubmed
Abstract:
Lung cancer remains the most common cause of cancer-related death in the United States. This study evaluated the costs of alternative diagnostic evaluations for patients with suspected non-small cell lung cancer (NSCLC). Researchers used a cost-minimization model to compare various diagnostic approaches in the evaluation of patients with NSCLC. It was less expensive to use an initial endoscopic ultrasound (EUS) with fine needle aspiration (FNA) to detect a mediastinal lymph node metastasis ($18,603 per patient), compared with combined EUS FNA and endobronchial ultrasound (EBUS) with FNA ($18,753). The results were sensitive to the prevalence of malignant mediastinal lymph nodes; EUS FNA remained least costly, if the probability of nodal metastases was <32.9%, as would occur in a patient without abnormal lymph nodes on computed tomography (CT). While EUS FNA combined with EBUS FNA was the most economical approach, if the rate of nodal metastases was higher, as would be the case in patients with abnormal lymph nodes on CT. Both of these strategies were less costly than bronchoscopy or mediastinoscopy. The pre-test probability of nodal metastases can determine the most cost-effective testing strategy for evaluation of a patient with NSCLC. Pre-procedure CT may be helpful in assessing probability of mediastinal nodal metastases.
Item Type:
Article
Language:
en
MeSH:
Bronchi; Bronchoscopy; Carcinoma, Non-Small-Cell Lung; Cost-Benefit Analysis; Endosonography; Humans; Lung Neoplasms; Lymph Nodes; Lymphatic Metastasis; Mediastinoscopy
ISSN:
1872-8332

Full metadata record

DC FieldValue Language
dc.contributor.authorHarewood, Gavin Cen
dc.contributor.authorPascual, Jorgeen
dc.contributor.authorRaimondo, Massimoen
dc.contributor.authorWoodward, Timothyen
dc.contributor.authorJohnson, Margareten
dc.contributor.authorMcComb, Barbaraen
dc.contributor.authorOdell, Johnen
dc.contributor.authorJamil, Laith Hen
dc.contributor.authorGill, Kanwar Rupinder Sen
dc.contributor.authorWallace, Michael Ben
dc.date.accessioned2011-04-06T14:55:36Z-
dc.date.available2011-04-06T14:55:36Z-
dc.date.issued2010-03-
dc.identifier.citationEconomic analysis of combined endoscopic and endobronchial ultrasound in the evaluation of patients with suspected non-small cell lung cancer. 2010, 67 (3):366-71 Lung Canceren
dc.identifier.issn1872-8332-
dc.identifier.pmid19473723-
dc.identifier.doi10.1016/j.lungcan.2009.04.019-
dc.identifier.urihttp://hdl.handle.net/10147/127525-
dc.description.abstractLung cancer remains the most common cause of cancer-related death in the United States. This study evaluated the costs of alternative diagnostic evaluations for patients with suspected non-small cell lung cancer (NSCLC). Researchers used a cost-minimization model to compare various diagnostic approaches in the evaluation of patients with NSCLC. It was less expensive to use an initial endoscopic ultrasound (EUS) with fine needle aspiration (FNA) to detect a mediastinal lymph node metastasis ($18,603 per patient), compared with combined EUS FNA and endobronchial ultrasound (EBUS) with FNA ($18,753). The results were sensitive to the prevalence of malignant mediastinal lymph nodes; EUS FNA remained least costly, if the probability of nodal metastases was <32.9%, as would occur in a patient without abnormal lymph nodes on computed tomography (CT). While EUS FNA combined with EBUS FNA was the most economical approach, if the rate of nodal metastases was higher, as would be the case in patients with abnormal lymph nodes on CT. Both of these strategies were less costly than bronchoscopy or mediastinoscopy. The pre-test probability of nodal metastases can determine the most cost-effective testing strategy for evaluation of a patient with NSCLC. Pre-procedure CT may be helpful in assessing probability of mediastinal nodal metastases.-
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2822087/?tool=pubmed-
dc.subject.meshBronchi-
dc.subject.meshBronchoscopy-
dc.subject.meshCarcinoma, Non-Small-Cell Lung-
dc.subject.meshCost-Benefit Analysis-
dc.subject.meshEndosonography-
dc.subject.meshHumans-
dc.subject.meshLung Neoplasms-
dc.subject.meshLymph Nodes-
dc.subject.meshLymphatic Metastasis-
dc.subject.meshMediastinoscopy-
dc.titleEconomic analysis of combined endoscopic and endobronchial ultrasound in the evaluation of patients with suspected non-small cell lung cancer.en
dc.typeArticleen
dc.contributor.departmentBeaumont Hospital, Beaumont Road, Dublin 9, Ireland.en
dc.identifier.journalLung cancer (Amsterdam, Netherlands)en
dc.description.provinceLeinster-

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