ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2019
A Value of Information Analysis of Research on the 21-Gene Assay for Breast Cancer Management.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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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.
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.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Component Clinical and Cost Outcomes Complementing Value of Information: Case Study of a Tuberculosis Diagnostics Clinical Trial.PharmacoEconomics · 2026Review
- Cost-Utility Analysis of Multigene Assays to Guide Treatment Decisions for Node-Negative Early Breast Cancer.Oncology and therapy · 2025Article
- Accurate EVSI Estimation for Nonlinear Models Using the Gaussian Approximation Method.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- Rapid Assessment of the Need for Evidence: Applying the Principles of Value of Information to Research Prioritisation.PharmacoEconomics · 2024Article
- Comment on: "Adding Value to CHEERS: New Reporting Standards for Value of Information Analyses".Applied health economics and health policy · 2024Article
- Cost-Effectiveness Analysis of the Oncotype DX Breast Recurrence ScoreClinicoEconomics and outcomes research : CEOR · 2024Article
- Cost-Effectiveness and Value of Information Analysis of an Ambient Intelligent Geriatric Management (AmbIGeM) System Compared to Usual Care to Prevent Falls in Older People in Hospitals.Applied health economics and health policy · 2023Article
- Population-Based Newborn Screening for Germline TP53 Variants: Clinical Benefits, Cost-Effectiveness, and Value of Further Research.Journal of the National Cancer Institute · 2022Article
- A Value-of-Information Framework for Personalizing the Timing of Surveillance Testing.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Article
- High-dimensional role of AI and machine learning in cancer research.British journal of cancer · 2022Review
- Early Cost-effectiveness Analysis of Risk-Based Selection Strategies for Adjuvant Treatment in Stage II Colon Cancer: The Potential Value of Prognostic Molecular Markers.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Article
- Computing the Expected Value of Sample Information Efficiently: Practical Guidance and Recommendations for Four Model-Based Methods.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 4 countries.
Funding
Abstract
objectivesThe 21-gene assay Oncotype DX (21-GA) shows promise as a guide in deciding when to initiate adjuvant chemotherapy in women with hormone receptor-positive early-stage breast cancer. Nevertheless, its routine use remains controversial, owing to insufficient evidence of its clinical utility and cost-effectiveness. Accordingly, we aim to quantify the value of conducting further research to reduce decision uncertainty in the use of the 21-GA.
methodsUsing value of information methods, we first generated probability distributions of survival and costs for decision making with and without the 21-GA alongside traditional risk prediction. These served as the input to a comparison of 3 alternative study designs: a retrospective observational study to update risk classification from the 21-GA, a prospective observational study to estimate prevalence of chemotherapy use, and a randomized controlled trial (RCT) of the 21-GA predictive value.
resultsWe found that current evidence strongly supports the use of the 21-GA in intermediate- and high-risk women. Further research should focus on low-risk women, among whom the cost-effectiveness findings remained equivocal. For this population, we identified a high value of reducing uncertainty in the 21-GA use for all proposed research studies. The RCT had the greatest potential to efficiently reduce the likelihood of choosing a suboptimal strategy, providing a value between $162 million and $1.1 billion at willingness-to-pay thresholds of $150 000 to $200 000/quality-adjusted life years.
conclusionFuture research to inform 21-GA decision making is of high value. The RCT of the 21-GA predictive value has the greatest potential to efficiently reduce decision uncertainty around 21-GA use in women with low-risk early-stage breast cancer.
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Registered trials
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.