Evidence map›Paper›PMID 34137520›Full record

ArticleCancer reports (Hoboken, N.J.)2022

The cost, survival, and quality-of-life implications of guideline-discordant imaging for prostate cancer.

Aaron N Winn, Matthew Kelly, Shannon Ciprut, Dawn Walter, Heather T Gold, Steven B Zeliadt, Scott E Sherman, Danil V Makarov

Abstract read
In one paragraph

Article in Cancer reports (Hoboken, N.J.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Systematic review of interventions that improve provider compliance to imaging guidelines for prostate cancer.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2022
    Review
  3. Review
  4. 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

8 authors.

Aaron N WinnSchool of Pharmacy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Matthew KellyDepartment of Urology, New York University School of Medicine, New York, USA.
Shannon CiprutDepartment of Urology, New York University School of Medicine, New York, USA.
Dawn WalterDepartment of Urology, New York University School of Medicine, New York, USA.
Heather T GoldDepartment of Population Health, New York University School of Medicine, New York, USA.
Steven B ZeliadtHealth Services Research and Development, Department of Veterans Affairs Medical Center, Seattle, Washington, USA.
Scott E ShermanDepartment of Population Health, New York University School of Medicine, New York, USA.
Danil V MakarovDepartment of Urology, New York University School of Medicine, New York, USA.

Funding

Edward Blank and Sharon-Cosloy Blank Family FoundationUS Department of Veterans Affairs CDA 11-257US Department of Veterans Affairs CDP 11-254
6 · The paper itself

Abstract

backgroundNational Comprehensive Cancer Network (NCCN) guidelines for incident prostate cancer staging imaging have been widely circulated and accepted as best practice since 1996. Despite these clear guidelines, wasteful and potentially harmful inappropriate imaging of men with prostate cancer remains prevalent.

aimTo understand changing population-level patterns of imaging among men with incident prostate cancer, we created a state-transition microsimulation model based on existing literature and incident prostate cancer cases.

methodsTo create a cohort of patients, we identified incident prostate cancer cases from 2004 to 2009 that were diagnosed in men ages 65 and older from SEER. A microsimulation model allowed us to explore how this cohort's survival, quality of life, and Medicare costs would be impacted by making imaging consistent with guidelines. We conducted a probabilistic analysis as well as one-way sensitivity analysis.

resultsWhen only imaging high-risk men compared to the status quo, we found that the population rate of imaging dropped from 53 to 38% and average per-person spending on imaging dropped from $236 to $157. The discounted and undiscounted incremental cost-effectiveness ratios indicated that ideal upfront imaging reduced costs and slightly improved health outcomes compared with current practice patterns, that is, guideline-concordant imaging was less costly and slightly more effective.

conclusionThis study demonstrates the potential reduction in cost through the correction of inappropriate imaging practices. These findings highlight an opportunity within the healthcare system to reduce unnecessary costs and overtreatment through guideline adherence.

Indexed as

Quality of LifeAgedCost-Benefit AnalysisDiagnostic ImagingGuideline AdherenceHumansMaleMedicareNeoplasm StagingProstatic NeoplasmsSEER ProgramUnited Statescancer carecost-effectivenesscostsprostate cancersimulation

Identifiers

PMID34137520
PMCPMC8842701

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.