Evidence map›Paper›PMID 38233699›Full record

ArticlePharmacoEconomics - open2024

Cost-Effectiveness Analysis of Digital Breast Tomosynthesis Added to Synthetic Mammography in Breast Cancer Screening in Brazil.

Henrique Lima Couto, Ludmila Peres Gargano, Vilmar Marques de Oliveira, Bertha Andrade Coelho, Eduardo Carvalho Pessoa, Augusto Tufi Hassan, Agnaldo Lopes Silva, Linei Augusta Brolini Delle Urban, Luciano Chala Fernandes, Nisha Sharma and 3 more

Abstract read
In one paragraph

Article in PharmacoEconomics - open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

13 authors.

Henrique Lima CoutoBrazilian Society of Mastology, Rio de Janeiro, Rio de Janeiro, Brazil. enriquecouto@hotmail.com.ORCID http://orcid.org/0000-0002-3789-4461
Ludmila Peres GarganoDepartment of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.ORCID http://orcid.org/0000-0002-0666-7776
Vilmar Marques de OliveiraBrazilian Society of Mastology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-9478-5616
Bertha Andrade CoelhoBrazilian Society of Mastology, Rio de Janeiro, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0001-9803-1427
Eduardo Carvalho PessoaBrazilian Society of Mastology, Rio de Janeiro, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0002-8330-0222
Augusto Tufi HassanBrazilian Society of Mastology, Rio de Janeiro, Rio de Janeiro, Brazil.ORCID http://orcid.org/0009-0005-5614-7508
Agnaldo Lopes SilvaBrazilian Federation of Associations of Gynecologists and Obstetricians, Rio de Janeiro, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0002-8486-7861
Linei Augusta Brolini Delle UrbanBrazilian College of Radiology, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0003-2017-9776
Luciano Chala FernandesBrazilian College of Radiology, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-8469-4681
Nisha SharmaBreast Screening Unit, Seacroft Hospital, Leeds Teaching Hospital NHS Trust, York Road, Leeds, West Yorkshire, LS146UH, UK.ORCID http://orcid.org/0000-0003-3991-0768
Ritse MannDepartment of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0001-8111-1930
Stuart A McIntoshPatrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK.ORCID http://orcid.org/0000-0002-4123-9611
Fernando ZangheliniMAPESolutions, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-4913-9498

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLiterature meta-analysis results show that digital breast tomosynthesis (DBT) combined with synthesized two-dimensional (s2D) mammograms can reduce recalls and improve breast cancer detection. Uncertainty regarding the screening of patients with breast cancer presents a health economic challenge, both in terms of healthcare resource use and quality of life impact on patients.

objectiveThis study aims to estimate the cost effectiveness of DBT + s2D versus digital mammography (DM) used in a biennial breast cancer screening setting of women aged 40-69 years with scattered areas of fibroglandular breast density and heterogeneous dense breasts in the Brazilian supplementary health system.

methodsA cost-effectiveness analysis was performed on the basis of clinical data obtained from a systematic review with meta-analysis performed to evaluate the analytical validity and clinical utility of DBT + s2D compared with DM. The search was conducted in the PubMed, Cochrane Library and Embase databases, with the main descriptors of the technology, a comparator, and the clinical condition in question, on 9 June 2022. The hybrid economic model (decision tree plus Markov model) simulated costs and outcomes over a lifetime for women aged 40-69 years with scattered areas of fibroglandular breast density and heterogeneous dense breasts. We analyzed incremental cost-effectiveness ratio (ICER) to measure the incremental cost difference per quality-adjusted life year (QALY) of adding DBT + s2D to breast cancer screening.

resultsDBT + s2D incurred a cost saving of € 954.02 per patient, in the time horizon of 30 years, compared with DM, and gained 5.1989 QALYs, which would be considered a dominant intervention. These results were confirmed in sensitivity analyses.

conclusionSwitching from DM to biennial DBT + s2D was cost effective. Furthermore, reductions in false-positive recall rates should also be considered in decision making.

Identifiers

PMID38233699
PMCPMC11058155

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.