Evidence map›Paper›PMID 32749212›Full record

ArticleRadiology2020

Cost-effectiveness of Digital Breast Tomosynthesis in Population-based Breast Cancer Screening: A Probabilistic Sensitivity Analysis.

Valérie D V Sankatsing, Karolina Juraniec, Sabine E Grimm, Manuela A Joore, Ruud M Pijnappel, Harry J de Koning, Nicolien T van Ravesteyn

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

Article in Radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 4 pooled it
2.0field-weighted citation impact, top 11% 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

14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Pooled it
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  3. Guideline
  4. The Use of Expert Elicitation among Computational Modeling Studies in Health Research: A Systematic Review.Medical decision making : an international journal of the Society for Medical Decision Making · 2022
    Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Valérie D V SankatsingFrom the Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (V.D.V.S., K.J., H.J.d.K., N.T.v.R.); Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht, the Netherlands (S.E.G., M.A.J.); Dutch Reference Center for Screening, Nijmegen, the Netherlands (R.M.P.); and Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (R.M.P.).ORCID 0000-0003-0052-2987
Karolina JuraniecFrom the Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (V.D.V.S., K.J., H.J.d.K., N.T.v.R.); Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht, the Netherlands (S.E.G., M.A.J.); Dutch Reference Center for Screening, Nijmegen, the Netherlands (R.M.P.); and Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (R.M.P.).ORCID 0000-0002-9392-467X
Sabine E GrimmFrom the Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (V.D.V.S., K.J., H.J.d.K., N.T.v.R.); Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht, the Netherlands (S.E.G., M.A.J.); Dutch Reference Center for Screening, Nijmegen, the Netherlands (R.M.P.); and Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (R.M.P.).ORCID 0000-0002-2175-7999
Manuela A JooreFrom the Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (V.D.V.S., K.J., H.J.d.K., N.T.v.R.); Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht, the Netherlands (S.E.G., M.A.J.); Dutch Reference Center for Screening, Nijmegen, the Netherlands (R.M.P.); and Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (R.M.P.).ORCID 0000-0002-5649-6768
Ruud M PijnappelFrom the Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (V.D.V.S., K.J., H.J.d.K., N.T.v.R.); Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht, the Netherlands (S.E.G., M.A.J.); Dutch Reference Center for Screening, Nijmegen, the Netherlands (R.M.P.); and Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (R.M.P.).
Harry J de KoningFrom the Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (V.D.V.S., K.J., H.J.d.K., N.T.v.R.); Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht, the Netherlands (S.E.G., M.A.J.); Dutch Reference Center for Screening, Nijmegen, the Netherlands (R.M.P.); and Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (R.M.P.).ORCID 0000-0003-4682-3646
Nicolien T van RavesteynFrom the Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands (V.D.V.S., K.J., H.J.d.K., N.T.v.R.); Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht, the Netherlands (S.E.G., M.A.J.); Dutch Reference Center for Screening, Nijmegen, the Netherlands (R.M.P.); and Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (R.M.P.).ORCID 0000-0003-3531-466X
Radboud University Nijmegen · NL

Funding

Comparative Modeling: Informing Breast Cancer Control Practice and PolicyU01CA199218 · NCI · GEORGETOWN UNIVERSITY · PI BERRY, DONALD A, DE KONING, HARRY J · 2015 to 2019
$9.0M
NCI NIH HHS U01 CA199218
6 · The paper itself

Abstract

BackgroundDigital breast tomosynthesis (DBT) is a promising screening test, but its outcomes and cost-effectiveness remain uncertain.PurposeTo determine if biennial DBT is cost-effective in a screening setting, when compared with digital mammography (DM) in the Netherlands, and to quantify the uncertainty.Materials and MethodsIn this study, performed from March 2018 to February 2019, the MIcrosimulation SCreening ANalysis model was used to conduct a probabilistic sensitivity analysis (PSA), consisting of 10 000 model runs with 1 000 000 women simulated per run. The Bayesian Cost-Effectiveness Analysis package and the Sheffield Accelerated Value of Information tool were used to process PSA outcomes. Two simulated cohorts born in 1970 were invited to undergo biennial screening between ages 50 and 74 years-one cohort was assigned to DM screening, and one was assigned to DBT screening. DM input parameters were based on data from the Dutch breast cancer screening program. DBT parameters were based on literature and expert opinion. Willingness-to-pay thresholds of €20 000 ($22 000) and €35 000 ($38 500) per life-year gained (LYG) were considered. Effects and costs were discounted at 3.5% per year.ResultsDBT resulted in a gain of 13 additional life-years per 1000 women invited to screening (7% increase, 13 of 193), followed over lifetime, compared with DM and led to 2% (four of 159) fewer false-positive results. DBT screening led to incremental discounted lifetime effects of 5.09 LYGs (95% confidence interval: -0.80, 9.70) and an increase in lifetime costs of €137 555 ($151 311) per 1000 women (95% confidence interval: €31 093 [$34 202], €263 537 [$289 891]) compared with DM, resulting in a mean incremental cost-effectiveness ratio of €27 023 ($29 725) per LYG. The probability of DBT being more cost-effective was 0.36 at €20 000 and 0.66 at €35 000 per LYG.ConclusionSwitching from digital mammography to biennial digital breast tomosynthesis is not cost-effective at a willingness-to-pay threshold of €20 000 per life-year gained, but digital breast tomosynthesis has a higher probability of being more cost-effective than digital mammography at a threshold of €35 000 per life-year gained.© RSNA, 2020

Indexed as

AgedBayes TheoremBreast NeoplasmsCost-Benefit AnalysisEarly Detection of CancerFemaleHumansLife ExpectancyMammographyMass ScreeningMiddle AgedSensitivity and Specificity

Identifiers

PMID32749212
PMCPMC7526946
OpenAlexW3047002381

What OpenQuestion holds

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Registered trials

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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.