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

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    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.
    Issue Date
    2010-03
    MeSH
    Bronchi
    Bronchoscopy
    Carcinoma, Non-Small-Cell Lung
    Cost-Benefit Analysis
    Endosonography
    Humans
    Lung Neoplasms
    Lymph Nodes
    Lymphatic Metastasis
    Mediastinoscopy
    
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    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)
    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
    ISSN
    1872-8332
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.lungcan.2009.04.019
    Scopus Count
    Collections
    Beaumont Hospital

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