Evidence map›Paper›PMID 35934771›Full record

ArticleApplied health economics and health policy2022

Cost-Effectiveness Analysis of Stockholm 3 Testing Compared to PSA as the Primary Blood Test in the Prostate Cancer Diagnostic Pathway: A Decision Tree Approach.

Bettina Wulff Risør, Nasrin Tayyari Dehbarez, Jacob Fredsøe, Karina Dalsgaard Sørensen, Bodil Ginnerup Pedersen

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Article in Applied health economics and health policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

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

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. Review
  7. Advancements in Biomarkers of Prostate Cancer: A Review.Technology in cancer research & treatment
    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

5 authors.

Bettina Wulff RisørDEFACTUM, Central Denmark Region, Olof Palmes Allé 15, 8200, Aarhus N, Denmark. betris@rm.dk.ORCID 0000-0003-3701-074X
Nasrin Tayyari DehbarezDEFACTUM, Central Denmark Region, Olof Palmes Allé 15, 8200, Aarhus N, Denmark.
Jacob FredsøeDepartment of Molecular Medicine (MOMA), Aarhus University Hospital, 8200, Aarhus N, Denmark.
Karina Dalsgaard SørensenDepartment of Molecular Medicine (MOMA), Aarhus University Hospital, 8200, Aarhus N, Denmark.
Bodil Ginnerup PedersenDepartment of Clinical Medicine, Aarhus University, 8200, Aarhus N, Denmark.

Funding

Innovationsfonden 8114-00027B
6 · The paper itself

Abstract

objectiveThis study evaluated the cost effectiveness of using Stockholm 3 (STHLM3) testing compared to the prostate-specific antigen (PSA) test in the diagnostic pathway for prostate cancer.

methodsWe created a decision tree model for PSA (current standard) and STHLM3 (new alternative). Cost effectiveness was evaluated in a hypothetical cohort of male individuals aged 50-69 years. The study applied a Danish hospital perspective with a time frame restricted to the prostate cancer diagnostic pathway, beginning with the initial PSA/STHLM3 test, and ending with biopsy and histopathological diagnosis. Estimated values from the decision-analytical model were used to calculate the incremental cost-effectiveness ratio. Deterministic and probabilistic sensitivity analyses were conducted to test the robustness of the base-case analysis.

resultsThe model-based analysis revealed that STHLM3 testing was more effective than the PSA, but also more costly, with an incremental cost-effectiveness ratio of €511.7 (95% credible interval, 359.9-674.3) for each additional correctly classified individual. In the deterministic sensitivity analysis, variations in the cost of STHLM3 had the greatest influence on the incremental cost-effectiveness ratio. In the probabilistic sensitivity analysis, all iterations were positioned in the north-east quadrant of the incremental cost-effectiveness scatterplot. At a willingness to pay of €700 for an additional correctly classified individual, STHLM3 had a 100% probability of being cost effective.

conclusionsCompared to the PSA test as the initial testing modality in the prostate cancer diagnostic workup, STHLM3 testing showed improved incremental effectiveness, however, at additional costs. The results were sensitive to the cost of the STHLM3 test; therefore, a lower cost of the STHLM3 test would improve its cost effectiveness compared with PSA tests.

Indexed as

Prostate-Specific AntigenProstatic NeoplasmsCost-Benefit AnalysisDecision TreesHematologic TestsHumansMaleQuality-Adjusted Life YearsProstate-Specific Antigen

Identifiers

PMID35934771
PMCPMC9596577

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