Details

Autor(en) / Beteiligte

• Eleuteri, Antonio
• Rola, Alda Cunha
• Kalirai, Helen
• Hussain, Rumana
• Sacco, Joseph
• Damato, Bertil E.
• Heimann, Heinrich
• Coupland, Sarah E.
• Taktak, Azzam F.G.

Titel

Cost-utility analysis of a decade of liver screening for metastases using the Liverpool Uveal Melanoma Prognosticator Online (LUMPO)

Ist Teil von

• Computers in biology and medicine, 2021-03, Vol.130, p.104221-104221, Article 104221

Ort / Verlag

United States: Elsevier Ltd

Erscheinungsjahr

2021

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• This paper outlines a method for cost-utility analysis of liver screening for metastases in patients with posterior uveal melanoma (UM). A semiparametric model of the cumulative incidence of onset of liver metastases was fitted to a retrospective data set of 615 subjects with clinical follow-up with respect to liver surveillance imaging and outcome. The model was internally validated via bootstrap resampling in terms of its discrimination and calibration performance. Receiver operating characteristics (ROC) were derived at different time points. The discrimination performances are consistent across time. The area under the ROC curve at 5 years post treatment was 0.85 [95% CI: 0.81–0.88]. A goodness-of-fit test gives χ2(10)=5.3,p=0.9 demonstrating no evidence against the null hypothesis of zero difference between observed and expected onset of metastatic events. Results showed that at 80% sensitivity, 87% of UM patients will avoid unnecessary radiological scans. This provides potential cost savings of between £46,000 and £97,000 per year to the National Health Service assuming 600 new cases per year. •Routine liver screening for UM metastases is time consuming and costly to patients and healthcare providers.•The application of LUMPO can enhance cost-effectiveness by reducing the number of screening examinations.•Significant cost savings can be made depending on number of cases and local practice.