Evidence map›Paper›PMID 29856875›Full record

ArticlePloS one2018

Costs and effects of intra-operative fluorescence molecular imaging - A model-based, early assessment.

Maximilian Präger, Marion Kiechle, Björn Stollenwerk, Christoph Hinzen, Jürgen Glatz, Matthias Vogl, Reiner Leidl

Abstract read
In one paragraph

Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Terahertz tomographic imaging of freshly excised human breast tissues.Journal of medical imaging (Bellingham, Wash.) · 2019
    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

7 authors.

Maximilian PrägerInstitute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health, Neuherberg, Germany.ORCID 0000-0003-2329-8279
Marion KiechleCenter for Hereditary Breast and Ovarian Cancer, Department of Gynecology, Klinikum Rechts der Isar, Technical University Munich (TUM), Munich, Germany.ORCID 0000-0003-4237-2657
Björn StollenwerkInstitute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health, Neuherberg, Germany.
Christoph HinzenInstitute of Biological and Medical Imaging, Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health, Neuherberg, Germany.
Jürgen GlatzInstitute of Biological and Medical Imaging, Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health, Neuherberg, Germany.
Matthias VoglInstitute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health, Neuherberg, Germany.
Reiner LeidlInstitute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH)-German Research Center for Environmental Health, Neuherberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSuccessful breast conserving cancer surgeries come along with tumor free resection margins and account for cosmetic outcome. Positive margins increase the likelihood of tumor recurrence. Intra-operative fluorescence molecular imaging (IFMI) aims to focus surgery on malignant tissue thus substantially lowering the presence of positive margins as compared with standard techniques of breast conservation (ST). A goal of this paper is to assess the incremental number of surgeries and costs of IFMI vs. ST.

methodsWe developed a decision analytical model and applied it for an early evaluation approach. Given uncertainty we considered that IFMI might reduce the proportion of positive margins found by ST from all to none and this proportion is assumed to be reduced to 10% for the base case. Inputs included data from the literature and a range of effect estimates. For the costs of IFMI, respective cost components were added to those of ST.

resultsThe base case reduction lowered number of surgeries (mean [95% confidence interval]) by 0.22 [0.15; 0.30] and changed costs (mean [95% confidence interval]) by €-663 [€-1,584; €50]. A tornado diagram identified the Diagnosis Related Group (DRG) costs, the proportion of positive margins of ST, the staff time saving factor and the duration of frozen section analysis (FSA) as important determinants of this cost.

conclusionsThese early results indicate that IFMI may be more effective than ST and through the reduction of positive margins it is possible to save follow-up surgeries-indicating further health risk-and to save costs through this margin reduction and the avoidance of FSA.

Indexed as

Margins of ExcisionMastectomy, SegmentalMolecular ImagingOptical ImagingSurgery, Computer-AssistedBenzenesulfonatesBevacizumabBreast NeoplasmsClinical Trials, Phase I as TopicDecision Support TechniquesFemaleFluorescent DyesFrozen SectionsGermanyHealth Care CostsHealth ExpendituresBenzenesulfonatesBevacizumabFluorescent DyesIndolesIRDye 800CW

Identifiers

PMID29856875
PMCPMC5983425

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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.