ArticleAnnals of internal medicine2014
Cost-effectiveness of the children's oncology group long-term follow-up screening guidelines for childhood cancer survivors at risk for treatment-related heart failure.
Article in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- Interventions to improve adherence to surveillance guidelines in survivors of childhood cancer: a systematic review.Journal of cancer survivorship : research and practice · 2019Pooled it
- Recommendations for cardiomyopathy surveillance for survivors of childhood cancer: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group.The Lancet. Oncology · 2015Guideline
- Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)-Positive Breast Cancer.JAMA network open · 2020Trial
- Increasing Cardiomyopathy Screening in Childhood Cancer Survivors: A Cost Analysis of Advanced Practice Nurse Phone Counseling.Oncology nursing forum · 2016Trial
- Echocardiographic Detection of Cardiac Dysfunction in Childhood Cancer Survivors: How Long Is Screening Required?Pediatric blood & cancer · 2015Trial
- Subclinical Cardiac Dysfunction in Childhood Cancer Survivors: Insights from Global Longitudinal Strain and Risk Factor Profiling.Indian pediatrics · 2026Observational
- The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers: A Review.JAMA oncology · 2025Review
- Cardiovascular Considerations After Cancer Therapy: Gaps in Evidence andJACC. CardioOncology · 2025Review
- Effectiveness and Cost-Effectiveness of Survivorship Care for Survivors of Hodgkin Lymphoma (INSIGHT Study): Protocol for a Multicenter Retrospective Cohort Study With a Quasi-Experimental Design.JMIR research protocols · 2024Article
- Improved Cardiomyopathy Risk Prediction Using Global Longitudinal Strain and N-Terminal-Pro-B-Type Natriuretic Peptide in Survivors of Childhood Cancer Exposed to Cardiotoxic Therapy.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
- Longitudinal adherence to surveillance for late effects of cancer treatment: a population-based study of adult survivors of childhood cancer.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Impact of Volumetric Dosimetry on the Projected Cost of Radiation-Related Late Effects Screening After Childhood Cancer: A Real-World Cohort Analysis.The oncologist · 2023Article
- Determinants of health-related quality-of-life in adult survivors of childhood cancer: integrating personal and societal values through a health utility approach.EClinicalMedicine · 2023Article
- Recent Advances in Serum Biomarkers for Risk Stratification and Patient Management in Cardio-Oncology.Current cardiology reports · 2023Review
- Article
- Is Electrocardiogram Helpful in Predicting a Rise in Troponin I as a Marker of Anthracycline Cardiotoxicity?European journal of breast health · 2022Article
- Delphi Panel Consensus Recommendations for Screening and Managing Childhood Cancer Survivors at Risk for Cardiomyopathy.JACC. CardioOncology · 2022Article
- PET Tracers for Imaging Cardiac Function in Cardio-oncology.Current cardiology reports · 2022Review
- Cancer and cardiovascular disease: can understanding the mechanisms of cardiovascular injury guide us to optimise care in cancer survivors?Ecancermedicalscience · 2022Review
- Leveraging Clinical Informatics Tools to Extract Cumulative Anthracycline Exposure, Measure Cardiovascular Outcomes, and Assess Guideline Adherence for Children With Cancer.JCO clinical cancer informatics · 2021Article
Corrections and comments
- Commented on by
Authors and funding
13 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundChildhood cancer survivors treated with anthracyclines are at high risk for asymptomatic left ventricular dysfunction (ALVD), subsequent heart failure, and death. The consensus-based Children's Oncology Group (COG) Long-Term Follow-up Guidelines recommend lifetime echocardiographic screening for ALVD.
objectiveTo evaluate the efficacy and cost-effectiveness of the COG guidelines and to identify more cost-effective screening strategies.
designSimulation of life histories using Markov health states. DATA SOURCES: Childhood Cancer Survivor Study; published literature. TARGET POPULATION: Childhood cancer survivors. TIME HORIZON: Lifetime. PERSPECTIVE: Societal.
interventionEchocardiographic screening followed by angiotensin-converting enzyme (ACE) inhibitor and β-blocker therapies after ALVD diagnosis. OUTCOME MEASURES: Quality-adjusted life-years (QALYs), costs, incremental cost-effectiveness ratios (ICERs) in dollars per QALY, and cumulative incidence of heart failure. RESULTS OF BASE-CASE ANALYSIS: The COG guidelines versus no screening have an ICER of $61 500, extend life expectancy by 6 months and QALYs by 1.6 months, and reduce the cumulative incidence of heart failure by 18% at 30 years after cancer diagnosis. However, less frequent screenings are more cost-effective than the guidelines and maintain 80% of the health benefits. RESULTS OF SENSITIVITY ANALYSIS: The ICER was most sensitive to the magnitude of ALVD treatment efficacy; higher treatment efficacy resulted in lower ICER. LIMITATION: Lifetime non-heart failure mortality and the cumulative incidence of heart failure more than 20 years after diagnosis were extrapolated; the efficacy of ACE inhibitor and β-blocker therapy in childhood cancer survivors with ALVD is undetermined (or unknown).
conclusionThe COG guidelines could reduce the risk for heart failure in survivors at less than $100 000/QALY. Less frequent screening achieves most of the benefits and would be more cost-effective than the COG guidelines.
Indexed as
Identifiers
What OpenQuestion holds
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.