Evidence map›Paper›PMID 25250815›Full record

ArticlePloS one2014

Cost-effectiveness of aspirin adjuvant therapy in early stage colorectal cancer in older patients.

Swee Sung Soon, Whay-Kuang Chia, Mun-ling Sarah Chan, Gwo Fuang Ho, Xiao Jian, Yan Hong Deng, Chuen-Seng Tan, Atul Sharma, Eva Segelov, Shaesta Mehta and 3 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 39% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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

13 authors at 10 institutions in 6 countries.

Swee Sung SoonDepartment of Pharmacy, National University of Singapore, Singapore, Singapore.
Whay-Kuang ChiaDepartment of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
Mun-ling Sarah ChanDepartment of Pharmacy, National University of Singapore, Singapore, Singapore.
Gwo Fuang HoDepartment of Radiation Oncology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Xiao JianDepartment of Medical Oncology, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Yan Hong DengDepartment of Medical Oncology, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Chuen-Seng TanSaw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Atul SharmaDepartment of Oncology, All India Institute of Medical Sciences, New Delhi, India.
Eva SegelovNational Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia.
Shaesta MehtaDepartment of Digestive Diseases and Nutrition, Tata Memorial Hospital, Mumbai, India.
Raghib AliNuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Han-Chong TohDepartment of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
Hwee-Lin WeeDepartment of Pharmacy, National University of Singapore, Singapore, Singapore.
National University of Singapore · SGNational Cancer Centre Singapore · SGAll India Institute of Medical Sciences · INNational Health and Medical Research Council · AUNational University Health System · SGSixth Affiliated Hospital of Sun Yat-sen University · CNSun Yat-sen University · CNTata Memorial Hospital · INUniversity Malaya Medical Centre · MYUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsRecent observational studies showed that post-operative aspirin use reduces cancer relapse and death in the earliest stages of colorectal cancer. We sought to evaluate the cost-effectiveness of aspirin as an adjuvant therapy in Stage I and II colorectal cancer patients aged 65 years and older.

methodsTwo five-state Markov models were constructed separately for Stage I and II colorectal cancer using TreeAge Pro 2014. Two hypothetical cohorts of 10,000 individuals at a starting age of 65 years and with colorectal cancer in remission were put through the models separately. Cost-effectiveness of aspirin was evaluated against no treatment (Stage I and II) and capecitabine (Stage II) over a 20-year period from the United States societal perspective. Extensive one-way sensitivity analyses and multivariable Probabilistic Sensitivity Analyses (PSA) were performed.

resultsIn the base case analyses, aspirin was cheaper and more effective compared to other comparators in both stages. Sensitivity analyses showed that no treatment and capecitabine (Stage II only) can be cost-effective alternatives if the utility of taking aspirin is below 0.909, aspirin's annual fatal adverse event probability exceeds 0.57%, aspirin's relative risk of disease progression is 0.997 or more, or when capecitabine's relative risk of disease progression is less than 0.228. Probabilistic Sensitivity Analyses (PSA) further showed that aspirin could be cost-effective 50% to 80% of the time when the willingness-to-pay threshold was varied from USD 20,000 to USD 100,000.

conclusionEven with a modest treatment benefit, aspirin is likely to be cost-effective in Stage I and II colorectal cancer, thus suggesting a potential unique role in secondary prevention in this group of patients.

Indexed as

Markov ChainsAgedAnti-Inflammatory Agents, Non-SteroidalAntimetabolites, AntineoplasticAspirinCapecitabineChemotherapy, AdjuvantColorectal NeoplasmsCost-Benefit AnalysisDeoxycytidineFluorouracilHumansModels, EconomicNeoplasm Recurrence, LocalNeoplasm StagingOutcome Assessment, Health CareAnti-Inflammatory Agents, Non-SteroidalAntimetabolites, AntineoplasticAspirinCapecitabineDeoxycytidineFluorouracil

Identifiers

PMID25250815
PMCPMC4176715
OpenAlexW2070775094

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.