Evidence map›Paper›PMID 38748377›Full record

ArticleJournal of epidemiology and global health2024

Cost-Effectiveness Analysis of Digital Breast Tomosynthesis and Mammography in Breast Cancer Screening: A Markov Modeling Study.

Wei-Shiuan Chung, Thomas T H Wan, Yu Tsz Shiu, Hon-Yi Shi

Abstract read
In one paragraph

Article in Journal of epidemiology and global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

  1. Pooled it
  2. 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

4 authors.

Wei-Shiuan ChungDepartment of Medical Imaging, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Thomas T H WanSchool of Global Health Management and Informatics, University of Central Florida, Orlando, USA.
Yu Tsz ShiuDepartment of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, Taiwan.
Hon-Yi ShiDepartment of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, Taiwan. hshi@kmu.edu.tw.

Funding

Ministry of Science and Technology 111-2410-H-037-002-MY3Ministry of Science and Technology MOST 108-2410-H-037-006-SS3
6 · The paper itself

Abstract

backgroundMammography (MG) has demonstrated its effectiveness in diminishing mortality and advanced-stage breast cancer incidences in breast screening initiatives. Notably, research has accentuated the superior diagnostic efficacy and cost-effectiveness of digital breast tomosynthesis (DBT). However, the scope of evidence validating the cost-effectiveness of DBT remains limited, prompting a requisite for more comprehensive investigation. The present study aimed to rigorously evaluate the cost-effectiveness of DBT plus MG (DBT-MG) compared to MG alone within the framework of Taiwan's National Health Insurance program.

methodsAll parameters for the Markov decision tree model, encompassing event probabilities, costs, and utilities (quality-adjusted life years, QALYs), were sourced from reputable literature, expert opinions, and official records. With 10,000 iterations, a 2-year cycle length, a 30-year time horizon, and a 2% annual discount rate, the analysis determined the incremental cost-effectiveness ratio (ICER) to compare the cost-effectiveness of the two screening methods. Probabilistic and one-way sensitivity analyses were also conducted to demonstrate the robustness of findings.

resultsThe ICER of DBT-MG compared to MG was US$5971.5764/QALYs. At a willingness-to-pay (WTP) threshold of US$33,004 (Gross Domestic Product of Taiwan in 2021) per QALY, more than 98% of the probabilistic simulations favored adopting DBT-MG versus MG. The one-way sensitivity analysis also shows that the ICER depended heavily on recall rates, biopsy rates, and positive predictive value (PPV2).

conclusionDBT-MG shows enhanced diagnostic efficacy, potentially diminishing recall costs. While exhibiting a higher biopsy rate, DBT-MG aids in the detection of early-stage breast cancers, reduces recall rates, and exhibits notably superior cost-effectiveness.

Indexed as

Breast NeoplasmsCost-Benefit AnalysisEarly Detection of CancerMammographyMarkov ChainsAgedCost-Effectiveness AnalysisFemaleHumansMiddle AgedQuality-Adjusted Life YearsTaiwanBreast cancer screeningCost-utility analysisDigital breast tomosynthesisMammographyMarkov model

Identifiers

PMID38748377
PMCPMC11442871

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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.