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Cost-effectiveness of a FISH assay for the diagnosis of melanoma in the USA.
- Source :
-
Expert review of pharmacoeconomics & outcomes research [Expert Rev Pharmacoecon Outcomes Res] 2013 Jun; Vol. 13 (3), pp. 371-80. Date of Electronic Publication: 2013 May 15. - Publication Year :
- 2013
-
Abstract
- Objective: The authors evaluated the cost-effectiveness of a FISH assay in melanoma diagnosis in the USA.<br />Method: A model was developed simulating the addition of FISH to the diagnosis of suspected melanoma. A decision analytic module simulated diagnosis using microscopic assessment alone versus addition of FISH (sensitivity: 92%; specificity: 94%). The authors simulated a clinical setting in which an initial excisional biopsy microscopic assessment (sensitivity: 73%; specificity: 78%) was followed by dermatopathologist assessment (sensitivity: 89%; specificity: 79%) for inconclusive results. Diagnostic strategies 1 and 2 added FISH to the initial and dermatopathologist assessments, respectively. A Markov outcomes module simulated patients' remaining lifetime, including treatment.<br />Results: In diagnostic strategies 1 and 2, the cost per quality-adjusted life year gained was US$14,930 and 43,925, respectively, versus no FISH. Cost per misdiagnosis avoided was US$3292 and 3759, respectively. Sensitivity and specificity without FISH were both ≥88%; however, addition of FISH exceeded US$100,000/quality-adjusted life year.<br />Conclusion: In specific clinical settings, FISH could be cost effective for melanoma diagnosis.
- Subjects :
- Cost-Benefit Analysis
Decision Support Techniques
Female
Humans
In Situ Hybridization, Fluorescence economics
Male
Markov Chains
Melanoma economics
Melanoma pathology
Middle Aged
Models, Economic
Quality-Adjusted Life Years
Sensitivity and Specificity
Skin Neoplasms economics
Skin Neoplasms pathology
United States
In Situ Hybridization, Fluorescence methods
Melanoma diagnosis
Skin Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1744-8379
- Volume :
- 13
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Expert review of pharmacoeconomics & outcomes research
- Publication Type :
- Academic Journal
- Accession number :
- 23672374
- Full Text :
- https://doi.org/10.1586/erp.13.22