Health State Utilities Associated with False-Positive Cancer Screening Results.

IF 2 Q2 ECONOMICS
PharmacoEconomics Open Pub Date : 2024-03-01 Epub Date: 2024-01-08 DOI:10.1007/s41669-023-00443-w
Louis S Matza, Timothy A Howell, Eric T Fung, Sam M Janes, Michael Seiden, Allan Hackshaw, Lincoln Nadauld, Hayley Karn, Karen C Chung
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引用次数: 0

Abstract

Introduction: Early cancer detection can significantly improve patient outcomes and reduce mortality rates. Novel cancer screening approaches, including multi-cancer early detection tests, have been developed. Cost-utility analyses will be needed to examine their value, and these models require health state utilities. The purpose of this study was to estimate the disutility (i.e., decrease in health state utility) associated with false-positive cancer screening results.

Methods: In composite time trade-off interviews using a 1-year time horizon, UK general population participants valued 10 health state vignettes describing cancer screening with true-negative or false-positive results. Each false-positive vignette described a common diagnostic pathway following a false-positive result suggesting lung, colorectal, breast, or pancreatic cancer. Every pathway ended with a negative result (no cancer detected). The disutility of each false positive was calculated as the difference between the true-negative and each false-positive health state, and because of the 1-year time horizon, each disutility can be interpreted as a quality-adjusted life-year decrement associated with each type of false-positive experience.

Results: A total of 203 participants completed interviews (49.8% male; mean age = 42.0 years). The mean (SD) utility for the health state describing a true-negative result was 0.958 (0.065). Utilities for false-positive health states ranged from 0.847 (0.145) to 0.932 (0.059). Disutilities for false positives ranged from - 0.031 to - 0.111 (- 0.041 to - 0.111 for lung cancer; - 0.079 for colorectal cancer; - 0.031 to - 0.067 for breast cancer; - 0.048 to - 0.088 for pancreatic cancer).

Conclusion: All false-positive results were associated with a disutility. Greater disutility was associated with more invasive follow-up diagnostic procedures, longer duration of uncertainty regarding the eventual diagnosis, and perceived severity of the suspected cancer type. Utility values estimated in this study would be useful for economic modeling examining the value of cancer screening procedures.

与癌症筛查假阳性结果相关的健康状态效用。
简介早期癌症检测可大大改善患者的预后并降低死亡率。目前已开发出新型癌症筛查方法,包括多种癌症早期检测试验。需要进行成本效用分析来研究其价值,而这些模型需要健康状态效用。本研究旨在估算与癌症筛查结果假阳性相关的不效用(即健康状态效用的降低):方法:在时间跨度为 1 年的综合时间权衡访谈中,英国普通人群参与者对 10 个描述癌症筛查真阴性或假阳性结果的健康状态小故事进行估值。每个假阳性小故事都描述了假阳性结果提示肺癌、结直肠癌、乳腺癌或胰腺癌后的常见诊断路径。每个路径都以阴性结果(未检测出癌症)结束。每个假阳性的效用被计算为真实阴性与每个假阳性健康状况之间的差异,由于时间跨度为 1 年,每个效用可被解释为与每种假阳性经历相关的质量调整生命年的减少:共有 203 名参与者完成了访谈(49.8% 为男性;平均年龄 = 42.0 岁)。描述真阴性结果的健康状况的效用平均值(标度)为 0.958 (0.065)。假阳性健康状况的效用介于 0.847 (0.145) 到 0.932 (0.059) 之间。假阳性结果的效用从-0.031到-0.111不等(肺癌为-0.041到-0.111;结肠直肠癌为-0.079;乳腺癌为-0.031到-0.067;胰腺癌为-0.048到-0.088):结论:所有假阳性结果都与效用降低有关。更高的效用损失与更具侵入性的后续诊断程序、最终诊断不确定性持续时间更长以及疑似癌症类型的严重程度有关。本研究估算出的效用值将有助于对癌症筛查程序的价值进行经济建模。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
64
审稿时长
8 weeks
期刊介绍: PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.
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