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Ahmad S, Stevenson J, Mangham C, Cribb G, Cool P. Accuracy of magnetic resonance imaging in planning the osseous resection margins of bony tumours in the proximal femur: based on coronal T1-weighted versus STIR images. Skeletal Radiol 2014; 43:1679-86. [PMID: 25119966 DOI: 10.1007/s00256-014-1979-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 07/27/2014] [Accepted: 07/30/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Assessment of the extent of tumours using magnetic resonance imaging (MRI) is the basis for bone resection in limb-salvage surgery. We aimed to compare the accuracy of T1-weighted MRI and STIR sequences in measuring the extent of proximal femoral tumours, using the macroscopic specimens as the gold standard for comparison. MATERIALS AND METHODS We compared single coronal T1-weighted with STIR sequences in 34 proximal femoral tumours, using bivalved resected macroscopic tumours for comparison. After randomisation, four observers measured longitudinal osseous tumour extent using MRI and specimen photographs on two separate occasions, 3 weeks apart. RESULTS There were 25 metastatic tumours, 8 chondrosarcomas and 1 myeloma. Eight patients presented with pathological fractures. The Pearson's correlation coefficient for comparison of T1 with macroscopic tumours was 0.91 (95% confidence interval [CI]: 0.83 to 0.96) for all observers and 0.90 (95% CI: 0.81 to 0.95) for STIR images. This difference was not statistically significant, and T1 and STIR sequence measurements had similar precision and accuracy. Bland-Altman plots showed T1-weighted imaging to be unbiased, whereas STIR sequences were biased and had systematic error. Moreover, STIR measurements overestimated tumour size by 6.4 mm (95% CI: -26.9 to 39.7 mm) and 2 patients were outliers. T1 measurements were closer to the macroscopic measurements with a mean difference of 1.3 mm (95% CI: -28.9 mm to 31.5 mm), with 3 patients falling outside of this. The variance was greater for STIR measurements. This difference between T1 and STIR measurements was statistically significant (p = 0.000003). The intra-observer reliability between separate measurements for MRI and specimen photographs achieved interclass correlation coefficients of 0.97, 0.96 and 0.95 (T1, STIR and macroscopic tumour respectively). T1 had greater interobserver correlation than for STIR and macroscopic tumour measurements (0.88 vs 0.85 and 0.85 respectively). These differences in interclass correlation were not statistically significant. CONCLUSION This study has shown T1-weighted MRI sequences to be unbiased compared with STIR sequences at determining intra-osseous tumour extent. STIR overestimates the length of bone tumours. T1 is therefore preferred for pre-operative planning for the resection of bone tumours.
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Varnold K, Calkins C, Nuttelmann B, Senaratne-Lenagala L, Stevenson J, Semler M, Chao M, Carr T, Erickson G. Background grazing, supplementation, finishing diet and aging affect biochemical constituents of beef bottom round steaks. Meat Sci 2014. [DOI: 10.1016/j.meatsci.2013.07.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Potts A, Donaghy M, Marley M, Othieno R, Stevenson J, Hyland J, Pollock KG, Lindsay D, Edwards G, Hanson MF, Helgason KO. Cluster of Legionnaires’ disease cases caused by Legionella longbeachae serogroup 1, Scotland, August to September 2013. Euro Surveill 2013; 18:20656. [DOI: 10.2807/1560-7917.es2013.18.50.20656] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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Conaglen PD, Laurenson IF, Sergeant A, Thorn SN, Rayner A, Stevenson J. Systematic review of tattoo-associated skin infection with rapidly growing mycobacteria and public health investigation of a cluster in Scotland, 2010. Euro Surveill 2013; 18:20553. [DOI: 10.2807/1560-7917.es2013.18.32.20553] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Sporadic cases and outbreaks of tattoo-associated skin infection with rapidly growing mycobacteria have been reported although they often contain few details of public health investigations and have not previously been systematically collated. We present the details of the public health investigation of a cluster of cases, which occurred in Scotland in 2010. Investigation of the cluster involved case finding, environmental investigation of the tattoo studio and pathological and microbiological investigation of possible cases and tattoo ink. Mycobacterium chelonae was isolated from one case and three probable cases were identified. M. chelonae was grown from an opened bottle of ink sourced from the studio these cases had attended. In addition, in order to identify all published cases, we conducted a systematic review of all reported cases of tattoo-associated skin infection with rapidly growing mycobacteria. A total of 25 reports were identified, describing 71 confirmed and 71 probable cases. Mycobacteria were isolated in 71 cases and M. chelonae was cultured from 48 of these. The most frequently postulated cause of infection was the dilution of black ink with tap water. Reports of tattoo-associated rapidly growing mycobacterial skin infection are increasing in frequency. Interested agencies must work with the tattoo industry to reduce the risk of contamination during tattoo ink manufacture, distribution and application.
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Mandal P, Craxton R, Chalmers JD, Gilhooley S, Laurenson IF, McSparron C, Stevenson J, Hill AT. Contact tracing in pulmonary and non-pulmonary tuberculosis. QJM 2012; 105:741-7. [PMID: 22408150 DOI: 10.1093/qjmed/hcs045] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIM The aim of our study was to determine the effectiveness of contact tracing for both pulmonary and non-pulmonary tuberculosis (TB). METHODS The authors studied contact tracing in South East of Scotland, Edinburgh TB Clinic, UK, for 3 years. New index cases of both pulmonary and non-pulmonary TB were identified from reviewing TB nurses records. Pulmonary involvement was excluded from all non-pulmonary cases. Active TB was diagnosed as per the national TB guidelines. Latent TB was diagnosed based on history, tuberculin skin test and interferon γ release assay. TB contacts were identified from reviewing TB nurses notes on index TB patients. A positive screening episode was defined as identification of either active or latent TB in a contact following relevant investigations. RESULTS Total number of positive screening episodes for pulmonary TB was 43.1% and non-pulmonary TB was 26.1%. Of these, 78.8% were household contacts and 21.2% were casual contacts. CONCLUSION Contact tracing in low-prevalence TB countries, for both pulmonary and non-pulmonary TB, is an essential intervention to identify and reduce the number of infected patients that will progress to active disease. This is the key for effective TB control.
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McCormick D, Thorn S, Milne D, Evans C, Stevenson J, Llano M, Donaghy M, on behalf of the Incident Management Team C. Public health response to an outbreak of Legionnaires’ disease in Edinburgh, United Kingdom, June 2012. Euro Surveill 2012; 17. [PMID: 22835439 DOI: 10.2807/ese.17.28.20216-en] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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Cheserem E, Stevenson J, Evason R, Brady M. O3 Gonorrhoea test of cure: outcomes in a large urban sexual health service. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601a.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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de la Haye B, Wild SH, Stevenson J, Johnston F, Blatchford O, Laurenson IF. Tuberculosis and alcohol misuse in Scotland: a population-based study using enhanced surveillance data. Int J Tuberc Lung Dis 2012; 16:886-90. [PMID: 22583556 DOI: 10.5588/ijtld.11.0624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To identify for the first time in Scotland the epidemiological characteristics of tuberculosis (TB) patients who misuse alcohol. DESIGN A retrospective cohort study using Enhanced Surveillance of Mycobacterial Infections (ESMI) scheme data for adult (aged ≥ 18 years) TB cases notified in Scotland, 2001-2007. Characteristics and treatment outcomes of TB cases with and without recorded alcohol misuse were compared. RESULTS Of 2419 adult TB cases, alcohol misuse was recorded in 426 (18%). Alcohol misuse was associated with male sex, White ethnicity, birth in the United Kingdom, unemployment, urban residence and socio-economic deprivation. Alcohol misusers were more likely than other TB cases to have pulmonary TB (92% vs. 61%, P < 0.001), be sputum smear-positive (74% vs. 58%, P < 0.001) and be enrolled on directly observed treatment (30% vs. 3%, P < 0.001). Treatment completion rates were respectively 77% and 79% (P = 0.34) in alcohol misusers and other TB cases. CONCLUSION We have identified epidemiological characteristics associated with alcohol misuse among TB patients in Scotland, notably socio-economic deprivation. We suggest improvements in data collection to allow more robust findings to inform policy decisions to assist the prevention and management of alcohol misuse and reduce the TB incidence in Scotland.
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Wheeler QD, Knapp S, Stevenson DW, Stevenson J, Blum SD, Boom BM, Borisy GG, Buizer JL, De Carvalho MR, Cibrian A, Donoghue MJ, Doyle V, Gerson EM, Graham CH, Graves P, Graves SJ, Guralnick RP, Hamilton AL, Hanken J, Law W, Lipscomb DL, Lovejoy TE, Miller H, Miller JS, Naeem S, Novacek MJ, Page LM, Platnick NI, Porter-Morgan H, Raven PH, Solis MA, Valdecasas AG, Van Der Leeuw S, Vasco A, Vermeulen N, Vogel J, Walls RL, Wilson EO, Woolley JB. Mapping the biosphere: exploring species to understand the origin, organization and sustainability of biodiversity. SYST BIODIVERS 2012. [DOI: 10.1080/14772000.2012.665095] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tiernan JF, Gilhooley S, Jones ME, Chalmers JD, McSparron C, Laurenson I, Stevenson J, Hill AT. P15 Does an interferon-gamma release assay change practice in patients referred to clinic for possible latent tuberculosis infection? Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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86
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Eblan M, Corradetti M, Lukens J, Christodouleas J, Rengan R, Langer C, Evans T, Stevenson J, Xanthopoulos E, Apisarnthanarax S. Brachial Plexopathy in Apical Non-small Cell Lung Cancer Treated with Definitive Radiation: Dosimetric Analysis and Clinical Implications. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Phillips C, Stevenson J, MacKenzie G. P1-288 Patterns of social inequality among cases of meningococcal infection in Scotland from 2005 to 2008. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976e.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND There is emerging evidence that sleep problems in childhood may have enduring consequences. Studies using parental and objective sleep measurement suggest that sleep difficulties in children may be associated with behavioural problems. However, the findings using objective sleep measures are inconsistent and it is not clear what aspects of sleep quality are associated with daytime behavioural difficulties. The aim of this paper is to identify which behavioural symptoms are best predicted by actigraphic sleep measures in a general population sample of school-aged children aged 6-11 years. METHODS Actigraphy was used to measure sleep in 91 typically developing children aged 6-11 years for 6 days. Parents completed the Strengths and Difficulties Questionnaire (SDQ). A series of multivariate linear regression models were computed to analyse the effects of sleep on SDQ subscales. RESULTS Sleep did not predict emotional symptoms or hyperactivity. After controlling for age and gender, sleep accounted for 18% of the variance in conduct problems. Only actual sleep time in minutes made a significant contribution to the model. CONCLUSIONS A child who sleeps 1 h less than the average child may be at risk of conduct problems. Clinicians should consider routinely screening for sleep difficulties when assessing children with conduct problems.
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Orisamolu A, Xanthopoulos E, Fernandes A, Christodouleas JP, Apisarnthanarax S, Mitra N, Wan F, Langer CJ, Evans TL, Stevenson J, Sterman D, Vachani A, Haas AR, Rengan R. Predictive factors for symptomatic radiation pneumonitis in 293 consecutively treated non-small cell lung cancer (NSCLC) patients receiving definitive radiation therapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Borghaei H, Mehra R, Millenson MM, Tuttle H, Ruth K, Magdalinski AJ, Mintzer DM, Lee J, Stevenson J, Langer CJ. Phase II study of bevacizumab and erlotinib in treatment-naive elderly patients (older than age 65) with advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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91
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Stevenson J. Congenital Large-Celled Alveolar Sarcoma. BRITISH MEDICAL JOURNAL 2011; 1:9-10. [PMID: 20748068 DOI: 10.1136/bmj.1.783.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Godwin A, Takahara G, Agnew M, Stevenson J. Functional data analysis as a means of evaluating kinematic and kinetic waveforms. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2010. [DOI: 10.1080/14639220903023368] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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93
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Cengel K, Fernandes A, Mick R, Culligan M, Smith D, Stevenson J, Sterman D, Glatstein E, Hahn S, Friedberg J. Multimodality Management of Malignant Pleural Mesothelioma. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Murthi P, Faisal FA, Rajaraman G, Stevenson J, Ignjatovic V, Monagle PT, Brennecke SP, Said JM. Placental biglycan expression is decreased in human idiopathic fetal growth restriction. Placenta 2010; 31:712-7. [PMID: 20591478 DOI: 10.1016/j.placenta.2010.05.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 05/07/2010] [Accepted: 05/24/2010] [Indexed: 11/28/2022]
Abstract
Fetal growth restriction (FGR) is a leading cause of perinatal morbidity and mortality. The majority of FGR cases are idiopathic and are associated with placental insufficiency, which can result from placental thrombosis. Evidence suggests that Dermatan Sulfate (DS) is an important anti-coagulant in placentae of uncomplicated pregnancies. This study hypothesised that the expression of biglycan proteoglycan, a source of DS, is decreased in idiopathic FGR placentae compared with placentae from uncomplicated pregnancies. This study aimed to determine biglycan mRNA, protein expression and spatial distribution in idiopathic FGR placentae compared with the placentae from gestation-matched controls. Biglycan mRNA expression, protein expression and spatial distribution was determined in 26 idiopathic FGR-affected placentae and 27 placentae from gestation-matched controls (27-40 weeks gestation) using real-time PCR, immunoblotting and immunohistochemistry, respectively. Mean biglycan mRNA expression was significantly decreased in FGR placentae compared with control placentae (2.87 +/- 0.55, (n = 26) vs. 4.48 +/- 0.85, (n = 27); t-test p = 0.01). FGR placentae demonstrated a trend towards decrease in mean biglycan protein expression compared with control placentae (0.86 +/- 0.22 (n = 9, FGR) vs, 1.9 +/- 0.56 (n = 7, control) p = 0.07). Biglycan immunoreactivity was detected in endothelial cells and sub-endothelial cells of the perivascular region of fetal capillaries. Semi-quantitative analyses demonstrated a significant decrease in immunoreactive biglycan in FGR placentae compared with control placentae (51.1 +/- 19.3 vs, 500.7 +/- 223, n = 6, p < 0.001). This is the first study to demonstrate decreased biglycan expression in idiopathic FGR placentae compared to gestation-matched controls. Reduced biglycan expression may contribute to placental thrombosis within the fetal vasculature, and may contribute to the pathogenesis of idiopathic FGR.
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Cengel KA, Fernandes A, Mick R, Smith D, Culligan M, Stevenson J, Sterman D, Glatstein E, Hahn SM, Friedberg JS. A multimodality treatment for malignant pleural mesothelioma patients with or without lymph node metastases. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Owens DA, Stevenson J, Osborn A, Geer J. Tracking the visual attention of novice and experienced drivers. J Vis 2010. [DOI: 10.1167/9.8.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rengan R, Mick R, Pryma D, Lin L, Maity A, Gupta A, Evans T, Stevenson J, Langer C, Hahn S. A Phase I Trial of the HIV Protease Inhibitor Nelfinavir with Concurrent Chemoradiotherapy (CT-RT) for Stage IIIA/IIIB NSCLC: A Report of Toxicities and Metabolic Response. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fernandes A, Lin L, Shen J, Finlay J, Evans T, Langer C, Stevenson J, Glatstein E, Hahn S, Rengan R. Predictive Factors for Mediastinal Nodal Failure in Locally-advanced Non–small–cell Lung Cancer (NSCLC) Patients Receiving Definitive Radiotherapy (RT). Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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McLeod C, Bagust A, Boland A, Hockenhull J, Dundar Y, Proudlove C, Davis H, Green J, Macbeth F, Stevenson J, Walley T, Dickson R. Erlotinib for the treatment of relapsed non-small cell lung cancer. HEALTH TECHNOLOGY ASSESSMENT (WINCHESTER, ENGLAND) 2009; 13 Suppl 1:41-7. [PMID: 19567213 DOI: 10.3310/hta13suppl1/07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This paper presents a summary of the evidence review group (ERG) report into the clinical and cost-effectiveness of erlotinib for the treatment of relapsed non-small cell lung cancer (NSCLC), according to its licensed indication, based upon the evidence submission from Roche Products to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal (STA) process. The submitted clinical evidence includes one randomised controlled trial (RCT) (BR21) investigating the effect of erlotinib versus placebo, which demonstrates that erlotinib significantly increases median overall survival, progression-free survival and response rate compared with placebo. The majority of patients in the trial experienced non-haematological drug-related adverse effects. Currently there are no trials that directly compare erlotinib with any other second-line chemotherapy agent. For the purposes of indirect comparison, the manufacturer's submission provides a narrative discussion of data from 11 RCTs investigating the use of docetaxel. From these data the manufacturer concludes that erlotinib has similar clinical efficacy levels to docetaxel but results in fewer serious haematological adverse events; however, it is difficult to compare the results of BR21 with those of the docetaxel trials or with current UK clinical practice because, for example, the BR21 patient population is younger than that expected to present in UK clinical practice and almost half of the BR21 participants received erlotinib as third-line chemotherapy, with third-line chemotherapy being rare in the UK. The manufacturer's submission included a three-state model comparing erlotinib with docetaxel, reporting an incremental cost-effectiveness ratio (ICER) of 1764 pounds per quality-adjusted life-year (QALY) gained for erlotinib compared with docetaxel. Rerunning the manufacturer's economic model with varied parameters and assumptions increases the ICER to in excess of 52,000 pounds per QALY gained. There is still a large amount of unquantifiable uncertainty in the model and it is unlikely that erlotinib could be considered to be cost-effective compared with docetaxel at a willingness to pay of 30,000 pounds and there may even be the potential for docetaxel to dominate erlotinib. Because of the limitations of the indirect analysis undertaken by the manufacturer and the subsequent economic modelling exercise there is a need for a head-to-head trial comparing erlotinib with docetaxel. The guidance issued by NICE in February 2007 as a result of the STA states that erlotinib is not recommended for the treatment of locally advanced or metastatic NSCLC.
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