Evidence map›Paper›PMID 29623628›Full record

ArticlePharmacoEconomics - open2018

Using Cerebrospinal Fluid Biomarker Testing to Target Treatment to Patients with Mild Cognitive Impairment: A Cost-Effectiveness Analysis.

Tzeyu L Michaud, Robert L Kane, J Riley McCarten, Joseph E Gaugler, John A Nyman, Karen M Kuntz

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In one paragraph

Article in PharmacoEconomics - open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

11 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Cost-effectiveness of testing biofluid biomarkers to diagnose Alzheimer's disease: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
    Pooled it
  2. Pooled it
  3. Pooled it
  4. How relevant are social costs in economic evaluations? The case of Alzheimer's disease.The European journal of health economics : HEPAC : health economics in prevention and care · 2019
    Pooled it
  5. Review
  6. Article
  7. Article
  8. State-of-the-art of lumbar puncture and its place in the journey of patients with Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2022
    Review
  9. Article
  10. Article
  11. Review
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

6 authors.

Tzeyu L MichaudCenter for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA. tzeyu.michaud@unmc.edu.ORCID http://orcid.org/0000-0002-2053-3942
Robert L KaneDivision of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
J Riley McCartenGeriatric Research, Education and Clinical Center, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA.
Joseph E GauglerSchool of Nursing and Center on Aging, University of Minnesota, Minneapolis, MN, USA.
John A NymanDivision of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Karen M KuntzDivision of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCerebrospinal fluid (CSF) biomarkers are shown to facilitate a risk identification of patients with mild cognitive impairment (MCI) into different risk levels of progression to Alzheimer's disease (AD). Knowing a patient's risk level provides an opportunity for earlier interventions, which could result in potential greater benefits. We assessed the cost effectiveness of the use of CSF biomarkers in MCI patients where the treatment decision was based on patients' risk level.

methodsWe developed a state-transition model to project lifetime quality-adjusted life-years (QALYs) and costs for a cohort of 65-year-old MCI patients from a US societal perspective. We compared four test-and-treat strategies where the decision to treat was based on a patient's risk level (low, intermediate, high) of progressing to AD with two strategies without testing, one where no patients were treated during the MCI phase and in the other all patients were treated. We performed deterministic and probabilistic sensitivity analyses to evaluate parameter uncertainty.

resultsTesting and treating low-risk MCI patients was the most cost-effective strategy with an incremental cost-effectiveness ratio (ICER) of US$37,700 per QALY. Our results were most sensitive to the level of treatment effectiveness for patients with mild AD and for MCI patients. Moreover, the ICERs for this strategy at the 2.5th and 97.5th percentiles were US$18,900 and US$50,100 per QALY, respectively.

conclusionBased on the best available evidence regarding the treatment effectiveness for MCI, this study suggests the potential value of performing CSF biomarker testing for early targeted treatments among MCI patients with a narrow range for the ICER.

Identifiers

PMID29623628
PMCPMC6103924

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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.