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 CPascual, 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
2010-03MeSH
BronchiBronchoscopy
Carcinoma, Non-Small-Cell Lung
Cost-Benefit Analysis
Endosonography
Humans
Lung Neoplasms
Lymph Nodes
Lymphatic Metastasis
Mediastinoscopy
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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 CancerJournal
Lung cancer (Amsterdam, Netherlands)DOI
10.1016/j.lungcan.2009.04.019PubMed ID
19473723Additional Links
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2822087/?tool=pubmedAbstract
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
ArticleLanguage
enISSN
1872-8332ae974a485f413a2113503eed53cd6c53
10.1016/j.lungcan.2009.04.019
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