Evidence map›Paper›PMID 27006643›Full record

ArticleCost effectiveness and resource allocation : C/E2016

The value of using a brain laser interstitial thermal therapy (LITT) system in patients presenting with high grade gliomas where maximal safe resection may not be feasible.

Jeffrey D Voigt, Gene Barnett

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cost effectiveness and resource allocation : C/E, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
2.8field-weighted citation impact, top 10% 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

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Article
  7. MRI-guided laser interstitial thermal therapy for deep-seated gliomas in children with neurofibromatosis type 1: report of two cases.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023
    Article
  8. Review
  9. Review
  10. Article
  11. International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2020
    Review
  12. Review
  13. Review
  14. MR Thermography-Guided Head and Neck Lesion Laser Ablation.AJNR. American journal of neuroradiology · 2018
    Review
  15. Article
  16. Surgical oncology for gliomas: the state of the art.Nature reviews. Clinical oncology · 2018
    Review
  17. Article
  18. Neurosurgical management of brain metastases.Clinical & experimental metastasis · 2017
    Review
  19. Article
  20. Thermal ablation in cancer.Oncology letters · 2016
    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

2 authors at 2 institutions in 1 country.

Jeffrey D Voigt99 Glenwood Rd, Ridgewood, NJ 07450 USA.
Gene BarnettThe Rose Ella Burkhardt Chair in Neurosurgical Oncology, The Cleveland Clinic, Lerner College of Medicine of Case Western Reserve University, The Cleveland Clinic S73, 9500 Euclid Avenue, Cleveland, OH 44195 USA ; Department of Neurological Surgery, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center Cleveland Clinic Neurological Institute, The Cleveland Clinic, S73, 9500 Euclid Avenue, Cleveland, OH 44195 USA.
Cleveland Clinic · USRidgewood Public Schools · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe objective of this analysis was to determine the value (incremental cost/increment benefit) of a brain LITT system versus employing current surgical options recommended by NCCN guidelines, specifically open resection (i.e. craniotomy) methods or biopsy (collectively termed CURRENT TREATMENTS) in patients where maximal safe resection may not be feasible. As has been demonstrated in the literature, extent of resection/ablation with minimal complications are independently related to overall survival.

methodsA cost effectiveness analysis from a societal perspective was employed using TreeAge Pro 2014 software. Direct costs (using national average Medicare reimbursement amounts), outcomes (overall survival), and value [defined as increment cost/incremental survival-evaluated as cost/life year gained (LYG)] were evaluated. Sensitivity analysis was also performed to determine which variables had the largest effect on incremental costs and outcomes.

resultsIn the base case, the overall survival was improved with brain LITT versus CURRENT TREATMENTS by 3.07 months at an additional cost of $7508 (or $29,340/LYG). This amount was significantly less than the current international threshold value for $32,575/LYG and considerably less than the US threshold value of $50,000/LYG. This incremental cost may also qualify under NICE criteria for end of life therapies. In sensitivity analysis: As percent local recurrence GBM increased; cost of DRG25/26 increased; percent GTR increased; and gliadel use increased-the value of brain LITT improved. Additionally, in those patients where a biopsy is the only option, brain LITT extended life by 7 months.

conclusionsBrain LITT should be considered a viable option for treatment of high grade gliomas as it improves survival at a cost which appears to be of good value to society. This incremental cost is less than the international and US thresholds for good value.

Indexed as

Brain LITTCost effectivenessLYGSurvivalValue

Identifiers

PMID27006643
PMCPMC4802786
OpenAlexW2307341157

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.