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High-resolution microendoscopy for esophageal cancer screening in China: A cost-effectiveness analysis

World Journal of Gastroenterology 2015年第18期21卷 5513-5523页

作者： Chin Hur Sung Eun Choi Chung Yin Kong Gui-Qi Wang Hong Xu Alexandros D Polydorides Li-Yan Xue Katherine E Perzan Angela C Tramontano rebecca r richards-Kortum Sharmila Anandasabapathy Institute for Technology Assessment Massachusetts General Hospital Harvard Medical School Boston MA 02114 United States Gastrointestinal Unit Massa- chusetts General Hospital Department of Endoscopy Cancer Institute and Hospital Chinese Academy of Medical Sciences Department of Endoscopy The First Hospital of Jilin University Department of Pathology The Mount Sinai Medical Center Icahn School of Medicine Department of Pathology Cancer Institute and Hospital Chinese Academy of Medical Sciences Department of Bioengineering Rice University Baylor Global Initiatives and the Baylor Global Innovation Center Baylor College of Medicine

AIM:To study the cost-effectiveness of high-resolution microendoscopy(HrME)in an esophageal squamous cell carcinoma(ESCC)screening program in ***:A decision analytic Markov model of ESCC was *** model analyses were conducted for cohorts consisting of an averagerisk population or a high-risk population in *** 50-year-old individuals were followed until age 80 or *** compared three different strategies for both cohorts:(1)no screening;(2)standard endoscopic screening with Lugol’s iodine staining;and(3)endoscopic screening with Lugol’s iodine staining and an *** parameters were estimated from the literature as well as from GLOBOcaN,the cancer Incidence and Mortality Worldwide cancer *** states in the model included non-neoplasia,mild dysplasia,moderate dysplasia,high-grade dysplasia,intramucosal carcinoma,operable cancer,inoperable cancer,and *** ESCC incidence transition rates were generated for the average-risk and high-risk *** in Chinese currency were converted to international dollars(I$)and were adjusted to 2012dollars using the Consumer Price ***:The main outcome measurements for this study were quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICEr).For the average-risk population,the HrME screening strategy produced 0.043 more QALYs than the no screening strategy at an additional cost of I$646,resulting in an ICEr of I$11808 per QALY *** endoscopic screening was weakly *** the high-risk population,when the HrME screening strategy was compared with the standard screening strategy,the ICEr was I$8173 per *** both the high-risk and average-risk screening populations,the HrME screening strategy appeared to be the most cost-effective strategy,producing ICErs below the willingness-topay threshold,I$23500 per ***-way sensitivity analysis showed that,for the average-risk population,higher specificity of Lugol’s i

关键词： Cost-effectiveness analysis Diagnostic imaging Endoscopy Esophageal squamous cell cancer Simulation disease model

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