Evidence map›Paper›PMID 28666368›Full record

ArticleNeuro-oncology2017

Cost-effectiveness of radiation and chemotherapy for high-risk low-grade glioma.

Yushen Qian, Satoshi Maruyama, Haju Kim, Erqi L Pollom, Kiran A Kumar, Alexander L Chin, Jeremy P Harris, Daniel T Chang, Allison Pitt, Eran Bendavid and 3 more

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

Article in Neuro-oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

12 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Cost-Effectiveness Analysis ofAJNR. American journal of neuroradiology · 2023
    Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. 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 3 institutions in 1 country.

Yushen QianDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Satoshi MaruyamaDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Haju KimDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Erqi L PollomDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Kiran A KumarDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Alexander L ChinDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Jeremy P HarrisDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Daniel T ChangDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Allison PittDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Eran BendavidDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Douglas K OwensDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Ben Y DurkeeDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
Scott G SoltysDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University, Stanford, California; Division of Management Science and Engineering, Department of Engineering, Stanford University, Stanford, California; VA Palo Alto Health Care System, and Center for Primary Care and Outcomes Research/Center for Health Policy, Department of Medicine, Stanford University, Stanford, California; Swedish American Hospital, a division of the University of Wisconsin, Rockford, Illinois.
VA Palo Alto Health Care System · USSwedish American Hospital · USStanford University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe addition of procarbazine, lomustine, vincristine (PCV) chemotherapy to radiotherapy (RT) for patients with high-risk (≥40 y old or subtotally resected) low-grade glioma (LGG) results in an absolute median survival benefit of over 5 years. We evaluated the cost-effectiveness of this treatment strategy.

methodsA decision tree with an integrated 3-state Markov model was created to follow patients with high-risk LGG after surgery treated with RT versus RT+PCV. Patients existed in one of 3 health states: stable, progressive, or dead. Survival and freedom from progression were modeled to reflect the results of RTOG 9802 using time-dependent transition probabilities. Health utility values and costs of care were derived from the literature and national registry databases. Analysis was conducted from the health care perspective. Deterministic and probabilistic sensitivity analysis explored uncertainty in model parameters.

resultsModeled outcomes demonstrated agreement with clinical data in expected benefit of addition of PCV to RT. The addition of PCV to RT yielded an incremental benefit of 4.77 quality-adjusted life-years (QALYs) (9.94 for RT+PCV vs 5.17 for RT alone) at an incremental cost of $48635 ($188234 for RT+PCV vs $139598 for RT alone), resulting in an incremental cost-effectiveness ratio of $10186 per QALY gained. Probabilistic sensitivity analysis demonstrates that within modeled distributions of parameters, RT+PCV has 99.96% probability of being cost-effectiveness at a willingness-to-pay threshold of $100000 per QALY.

conclusionThe addition of PCV to RT is a cost-effective treatment strategy for patients with high-risk LGG.

Indexed as

Cost-Benefit AnalysisDecision TreesAdultAntineoplastic Combined Chemotherapy ProtocolsBrain NeoplasmsChemoradiotherapyDisease ProgressionGliomaHumansLomustineNeoplasm GradingProcarbazineQuality-Adjusted Life YearsSurvival RateTreatment OutcomeVincristineLomustineProcarbazineVincristinebrain tumorchemotherapycost-effectiveness analysislow-grade gliomaradiotherapy

Identifiers

PMID28666368
PMCPMC5716167
OpenAlexW2729446362

What OpenQuestion holds

Textmetadata
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.