Lu B, Sun LX, Yan X, Ai ZZ, Xu JZ. Decision-tree analysis for cost-effective management of solitary pulmonary nodules in China.
World J Meta-Anal 2014;
2:127-134. [DOI:
10.13105/wjma.v2.i3.127]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/17/2014] [Accepted: 07/18/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To analyze the cost-effectiveness of the diagnosis of solitary pulmonary nodule (SPN) in China.
METHODS: Decision analysis models were constructed to assess the cost-effectiveness of four strategies for the management of SPN: computed tomography (CT) alone, CT plus CT-guided automated cutting needle biopsy (ACNB), CT plus positron emission tomography/computed tomography (PET/CT), CT plus diffusion-weighted magnetic resonance imaging (DWI) plus PET/CT.
RESULTS: The prevalence of lung cancer among SPN discovered in the clinical setting was approximately 50%. The CT plus ACNB strategy had higher diagnostic accuracies (87% vs 81%), with a cost saving of ￥1945 RMB per patient, and reducing unnecessary thoracotomy by 16.5%; this was associated with a 4.5% missed diagnosis rate. CT plus DWI plus PET/CT strategy also had higher accuracies (95% vs 81%), with a cost saving of ￥590 RMB per patient, and reducing unnecessary thoracotomy by 13.5%; this was accompanied by 0.3% missed diagnosis rate. CT plus PET strategy is cost effective at a prevalence rate of 0-34%, but there was a larger prevalence range of lung cancer for CT plus ACNB strategy (from 0 to 0.6) and CT plus DWI plus PET/CT strategy(from 0 to 0.64).
CONCLUSION: CT plus DWI plus PET/CT strategy was cost-effective, and had a higher accuracy accompanied by a lower missed diagnosis rate than CT plus ACNB strategy.
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