ArticleCHEST pulmonary2024
Cost-Effectiveness of Rapid On-Site Evaluation During Navigational Bronchoscopy.
Article in CHEST pulmonary, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Peripheral pulmonary lesions (PPLs) are common, with > 1.6 million PPLs incidentally identified in the United States annually. Navigational bronchoscopy (NB) is a cornerstone of the diagnostic evaluation of PPLs. Intraprocedural rapid on-site evaluation (ROSE) of biopsies obtained during NB is widely used, but the data for its utility are contradictory. The cost-effectiveness of ROSE has yet to be established; as such, ROSE currently has variable implementation between institutions and is not adequately reimbursed by payers. Research Question: Is ROSE cost-effective during NB for PPLs from a third-party payer perspective? Study Design and Methods: A cost-effectiveness model was constructed comparing NB for PPLs with vs without ROSE from a third-party payer perspective. The base case is a 60-year-old operative candidate with a 2-cm pulmonary nodule without radiographic mediastinal or hilar lymphadenopathy referred for NB. Cost per quality-adjusted life year gained was the primary outcome. Inputs for the model were estimated from published literature. One-way deterministic sensitivity analyses were conducted on all parameters. Probabilistic sensitivity analysis was performed. Results: The use of ROSE resulted in a gain of 0.01 quality-adjusted life years and cost an additional $466. At a willingness-to-pay threshold of $100,000/life year, ROSE was cost-effective with an incremental cost-effectiveness ratio of $44,465.88. Sensitivity analyses on the sensitivity of NB with and without ROSE show that ROSE must increase the diagnostic sensitivity of the procedure by 3% to become cost-effective. Interpretation: Our findings show that the use of ROSE during NB for PPLs is cost-effective for third-party payers at a willingness-to-pay threshold of $100,000/life year and should be reimbursed at a higher rate. The cost-effectiveness of ROSE hinges on the additional diagnostic sensitivity gained by using ROSE.
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Registered trials
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