ArticleThe Annals of thoracic surgery2014
Cost-effectiveness of initial diagnostic strategies for pulmonary nodules presenting to thoracic surgeons.
Article in The Annals of thoracic surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis 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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- EarlyCDT Lung blood test for risk classification of solid pulmonary nodules: systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2022Pooled it
- Ultrathin bronchoscopy for solitary pulmonary lesions in a region endemic for tuberculosis: a randomised pilot trial.BMC pulmonary medicine · 2016Trial
- Cost-effectiveness analysis of artificial intelligence-assisted risk stratification of indeterminate pulmonary nodules.PloS one · 2026Article
- Development and deployment of robots in a bronchoscopy suite.Breathe (Sheffield, England) · 2025Review
- Evaluation of electromagnetic navigational bronchoscopic biopsy of lung lesions performed by a thoracic surgical service.Surgery · 2023Article
- Endoscopic Technologies for Peripheral Pulmonary Lesions: From Diagnosis to Therapy.Life (Basel, Switzerland) · 2023Review
- Safety and Diagnostic Yield of Transthoracic Needle Aspiration of the Lung in Elderly Patients.Lung · 2021Article
- Conventional Computed Tomographic Calcium Scoring vs full chest CTCS for lung cancer screening: a cost-effectiveness analysis.BMC pulmonary medicine · 2020Article
- Diagnostic Performance of PET or PET/CT with Different Radiotracers in Patients with Suspicious Lung Cancer or Pleural Tumours according to Published Meta-Analyses.Contrast media & molecular imaging · 2020Review
- Risk Prediction in Clinical Practice: A Practical Guide for Cardiothoracic Surgeons.The Annals of thoracic surgery · 2019Article
- Accuracy of a Novel Histoplasmosis Enzyme Immunoassay to Evaluate Suspicious Lung Nodules.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2019Article
- Assessment of Fluorodeoxyglucose F18-Labeled Positron Emission Tomography for Diagnosis of High-Risk Lung Nodules.JAMA surgery · 2018Article
- Communication About the Probability of Cancer in Indeterminate Pulmonary Nodules.JAMA surgery · 2018Article
- Article
- Lung Cancer Diagnosis by Fine Needle Aspiration Is Associated With Reduction in Resection of Nonmalignant Lung Nodules.The Annals of thoracic surgery · 2017Article
- Navigational bronchoscopy at a community hospital: clinical and economic outcomes.Lung cancer management · 2016Article
- Design of a prospective, multicenter, global, cohort study of electromagnetic navigation bronchoscopy.BMC pulmonary medicine · 2016Review
- Navigational transbronchial needle aspiration, percutaneous needle aspiration and its future.Journal of thoracic disease · 2015Review
- Implications of Preoperative Transbronchial Lung Biopsy for Non-small Cell Lung Cancer Less than 3-cm.In vivo (Athens, Greece)Article
- Use of PET/CT to aid clinical decision-making in cases of solitary pulmonary nodule: a probabilistic approach.Radiologia brasileiraArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPatients presenting to thoracic surgeons with pulmonary nodules suggestive of lung cancer have varied diagnostic options including navigation bronchoscopy (NB), computed tomography-guided fine-needle aspiration (CT-FNA), (18)F-fluoro-deoxyglucose positron emission tomography (FDG-PET) and video-assisted thoracoscopic surgery (VATS). We studied the relative cost-effective initial diagnostic strategy for a 1.5- to 2-cm nodule suggestive of cancer.
methodsA decision analysis model was developed to assess the costs and outcomes of four initial diagnostic strategies for diagnosis of a 1.5- to 2-cm nodule with either a 50% or 65% pretest probability of cancer. Medicare reimbursement rates were used for costs. Quality-adjusted life years were estimated using patient survival based on pathologic staging and utilities derived from the literature.
resultsWhen cancer prevalence was 65%, tissue acquisition strategies of NB and CT-FNA had higher quality-adjusted life years compared with either FDG-PET or VATS, and VATS was the most costly strategy. In sensitivity analyses, NB and CT-FNA were more cost-effective than FDG-PET when FDG-PET specificity was less than 72%. When cancer prevalence was 50%, NB, CT-FNA, and FDG-PET had similar cost-effectiveness.
conclusionsBoth NB and CT-FNA diagnostic strategies are more cost-effective than either VATS biopsy or FDG-PET scan to diagnose lung cancer in moderate- to high-risk nodules and resulted in fewer nontherapeutic operations when FDG-PET specificity was less than 72%. An FDG-PET scan for diagnosis of lung cancer may not be cost-effective in regions of the country where specificity is low.
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.