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Cost-effectiveness Analysis of Screening Extremely Low Birth Weight Children for Hepatoblastoma Using Serum Alpha-fetoprotein.
- Source :
-
The Journal of pediatrics [J Pediatr] 2020 Oct; Vol. 225, pp. 80-89.e4. Date of Electronic Publication: 2020 May 26. - Publication Year :
- 2020
-
Abstract
- Objectives: To evaluate the cost-effectiveness of screening children born at extremely low birth weight (ELBW) for hepatoblastoma using serial serum alpha-fetoprotein measurements.<br />Study Design: We created a decision tree to evaluate the cost effectiveness of screening children born at ELBW between 3 and 48 months of age compared with current standard of care (no screening). Our model used discounted lifetime costs and monetary benefits in 2018 US dollars, based on estimates in the published literature. The effects of uncertainty in model parameters were also assessed using univariate sensitivity analyses, in which we changed the values for one parameter at a time to assess the effect on the estimated incremental cost-effectiveness ratio.<br />Results: For the estimated 55 699 children born at ELBW in the US each year, this screening is associated with 77.7 additional quality-adjusted life-years (QALYs) at a cost of $8.7 million. This results in an incremental cost-effectiveness ratio of about $112 000/QALY, which is considered cost effective from a US societal perspective. For children diagnosed with hepatoblastoma, our model finds that the screening regimen is associated with a 10.1% increase in survival, a 4.18% increase in expected QALYs, and a $245 184 decrease in expected cost.<br />Conclusions: Screening ELBW children for hepatoblastoma between 3 and 48 months of age dominates the alternative and is cost effective from a societal perspective.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Child
Child, Preschool
Cost-Benefit Analysis
Decision Trees
Health Care Costs
Hepatoblastoma blood
Humans
Incidence
Infant
Infant, Extremely Low Birth Weight
Infant, Newborn
Liver Neoplasms blood
Quality-Adjusted Life Years
United States
Hepatoblastoma diagnosis
Hepatoblastoma epidemiology
Liver Neoplasms diagnosis
Liver Neoplasms epidemiology
Neonatal Screening economics
Neonatal Screening methods
alpha-Fetoproteins analysis
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6833
- Volume :
- 225
- Database :
- MEDLINE
- Journal :
- The Journal of pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 32470475
- Full Text :
- https://doi.org/10.1016/j.jpeds.2020.05.041