Evidence map›Paper›PMID 14715603›Full record

ArticleBMJ (Clinical research ed.)2004

Cost effectiveness analysis of intensive versus conventional follow up after curative resection for colorectal cancer.

Andrew G Renehan, Sarah T O'Dwyer, David K Whynes

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Pooled it
  7. Colorectal cancer (CRC) monitoring by 6-monthly 18FDG-PET/CT: an open-label multicentre randomised trial.Annals of oncology : official journal of the European Society for Medical Oncology · 2018
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  9. Colorectal Cancer Recurrence Prediction Using a Tissue-Free Epigenomic Minimal Residual Disease Assay.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024
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  20. In Reply.The oncologist · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Andrew G RenehanDepartment of Surgery, Christie Hospital NHS Trust, Withington, Manchester M20 4BX. arenehan@picr.man.ac.uk
Sarah T O'Dwyer
David K Whynes

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the cost effectiveness of intensive follow up compared with conventional follow up in patients with colorectal cancer.

designIncremental cost effectiveness analysis recognising differences in follow up strategies, based on effectiveness data from a meta-analysis of five randomised trials.

settingUnited Kingdom.

main outcome measuresTaking a health service perspective, estimated incremental costs effectiveness ratios for each life year gained for five trials and four trials designed for early detection of extramural recurrences (targeted surveillance).

resultsBased on five year follow up, the numbers of life years gained by intensive follow up were 0.73 for the five trial model and 0.82 for the four trial model. For the five trials, the adjusted net (extra) cost for each patient was 2479 pounds sterling (3550 euros; 4288 dollars) and for each life year gained was 3402 pounds sterling, substantially lower than the current threshold of NHS cost acceptability (30 000 pounds sterling). The corresponding values for the four trial model were 2529 pounds sterling and 3077 pounds sterling, suggesting that targeted surveillance is more cost effective. The main predictor of incremental cost effectiveness ratios was surveillance costs rather than treatment costs. Judged against the NHS threshold of cost acceptability, the predicted incremental cost threshold was ninefold and the effectiveness threshold was 3%.

conclusionsBased on the available data and current costs, intensive follow up after curative resection for colorectal cancer is economically justified and should be normal practice. There is a continuing need to evaluate the efficacy of specific surveillance tools: this study forms the basis for economic evaluations in such trials.

Indexed as

Colorectal NeoplasmsCost-Benefit AnalysisFollow-Up StudiesHealth Care CostsHumansRandomized Controlled Trials as TopicTreatment Outcome

Identifiers

PMID14715603
PMCPMC314047

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.