ArticleBMC medical research methodology2013
From accuracy to patient outcome and cost-effectiveness evaluations of diagnostic tests and biomarkers: an exemplary modelling study.
Article in BMC medical research methodology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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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.
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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.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- A Systematic Literature Review of Modelling Approaches to Evaluate the Cost Effectiveness of PET/CT for Therapy Response Monitoring in Oncology.PharmacoEconomics · 2025Pooled it
- Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2013Pooled it
- How accurate should a precision medical test be to meet cost-effectiveness.Cost effectiveness and resource allocation : C/E · 2026Article
- A rare pediatric case: Budd-Chiari Syndrome and upper gastrointestinal bleeding in a 5-year-old boy.International journal of surgery case reports · 2025Article
- Cost-effectiveness of one-stop-shop [European journal of nuclear medicine and molecular imaging · 2024Article
- Cost-consequence analysis of computer vision-based skin prick tests: implications for cost containment in Switzerland.BMC health services research · 2024Article
- A scoping review of complication prediction models in spinal surgery: An analysis of model development, validation and impact.North American Spine Society journal · 2022Article
- Methodological standards for the development and evaluation of clinical prediction rules: a review of the literature.Diagnostic and prognostic research · 2019Review
- Toward Alignment in the Reporting of Economic Evaluations of Diagnostic Tests and Biomarkers: The AGREEDT Checklist.Medical decision making : an international journal of the Society for Medical Decision Making · 2018Review
- Biomarkers: Delivering on the expectation of molecularly driven, quantitative health.Experimental biology and medicine (Maywood, N.J.) · 2018Review
- The early economic evaluation of novel biomarkers to accelerate their translation into clinical applications.Cost effectiveness and resource allocation : C/E · 2018Article
- Evaluating the impact of prediction models: lessons learned, challenges, and recommendations.Diagnostic and prognostic research · 2018Article
- Methodologic approaches to evaluating new highly sensitive diagnostic tests: avoiding overdiagnosis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Review
- Using evidence to combat overdiagnosis and overtreatment: evaluating treatments, tests, and disease definitions in the time of too much.PLoS medicine · 2014Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProper evaluation of new diagnostic tests is required to reduce overutilization and to limit potential negative health effects and costs related to testing. A decision analytic modelling approach may be worthwhile when a diagnostic randomized controlled trial is not feasible. We demonstrate this by assessing the cost-effectiveness of modified transesophageal echocardiography (TEE) compared with manual palpation for the detection of atherosclerosis in the ascending aorta.
methodsBased on a previous diagnostic accuracy study, actual Dutch reimbursement data, and evidence from literature we developed a Markov decision analytic model. Cost-effectiveness of modified TEE was assessed for a life time horizon and a health care perspective. Prevalence rates of atherosclerosis were age-dependent and low as well as high rates were applied. Probabilistic sensitivity analysis was applied.
resultsThe model synthesized all available evidence on the risk of stroke in cardiac surgery patients. The modified TEE strategy consistently resulted in more adapted surgical procedures and, hence, a lower risk of stroke and a slightly higher number of life-years. With 10% prevalence of atherosclerosis the incremental cost-effectiveness ratio was € 4,651 and € 481 per quality-adjusted life year in 55-year-old men and women, respectively. In all patients aged 65 years or older the modified TEE strategy was cost saving and resulted in additional health benefits.
conclusionsDecision analytic modelling to assess the cost-effectiveness of a new diagnostic test based on characteristics, costs and effects of the test itself and of the subsequent treatment options is both feasible and valuable. Our case study on modified TEE suggests that it may reduce the risk of stroke in cardiac surgery patients older than 55 years at acceptable cost-effectiveness levels.
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Registered trials
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.