A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk
Gastric cancer (GC) surveillance based on oesophagogastroduodenoscopy (OGD) appears to be a promising strategy for GC prevention. By evaluating the cost-effectiveness of endoscopic surveillance in Singaporean Chinese, this study aimed to inform the implementation of such a program in a population wi...
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| creator | Zhou, Hui Jun Dan, Yock Young Naidoo, Nasheen Li, Shu Chuen Yeoh, Khay Guan |
| description | Gastric cancer (GC) surveillance based on oesophagogastroduodenoscopy (OGD) appears to be a promising strategy for GC prevention. By evaluating the cost-effectiveness of endoscopic surveillance in Singaporean Chinese, this study aimed to inform the implementation of such a program in a population with a low to intermediate GC risk.
USING A REFERENCE STRATEGY OF NO OGD INTERVENTION, WE EVALUATED FOUR STRATEGIES: 2-yearly OGD surveillance, annual OGD surveillance, 2-yearly OGD screening and 2-yearly screening plus annual surveillance in Singaporean Chinese aged 50-69 years. From a perspective of the healthcare system, Markov models were built to simulate the life experience of the target population. The models projected discounted lifetime costs ($), quality adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER) indicating the cost-effectiveness of each strategy against a Singapore willingness-to-pay of $46,200/QALY. Deterministic and probabilistic sensitivity analyses were used to identify the influential variables and their associated thresholds, and to quantify the influence of parameter uncertainties respectively.
With an ICER of $44,098/QALY, the annual OGD surveillance was the optimal strategy while the 2-yearly surveillance was the most cost-effective strategy (ICER = $25,949/QALY). The screening-based strategies were either extendedly dominated or cost-ineffective. The cost-effectiveness heterogeneity of the four strategies was observed across age-gender subgroups. Eight influential parameters were identified each with their specific thresholds to define the choice of optimal strategy. Accounting for the model uncertainties, the probability that the annual surveillance is the optimal strategy in Singapore was 44.5%.
Endoscopic surveillance is potentially cost-effective in the prevention of GC for populations at low to intermediate risk. Regarding program implementation, a detailed analysis of influential factors and their associated thresholds is necessary. Multiple strategies should be considered in order to recommend the right strategy for the right population. |
| doi_str_mv | 10.1371/journal.pone.0083959 |
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USING A REFERENCE STRATEGY OF NO OGD INTERVENTION, WE EVALUATED FOUR STRATEGIES: 2-yearly OGD surveillance, annual OGD surveillance, 2-yearly OGD screening and 2-yearly screening plus annual surveillance in Singaporean Chinese aged 50-69 years. From a perspective of the healthcare system, Markov models were built to simulate the life experience of the target population. The models projected discounted lifetime costs ($), quality adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER) indicating the cost-effectiveness of each strategy against a Singapore willingness-to-pay of $46,200/QALY. Deterministic and probabilistic sensitivity analyses were used to identify the influential variables and their associated thresholds, and to quantify the influence of parameter uncertainties respectively.
With an ICER of $44,098/QALY, the annual OGD surveillance was the optimal strategy while the 2-yearly surveillance was the most cost-effective strategy (ICER = $25,949/QALY). The screening-based strategies were either extendedly dominated or cost-ineffective. The cost-effectiveness heterogeneity of the four strategies was observed across age-gender subgroups. Eight influential parameters were identified each with their specific thresholds to define the choice of optimal strategy. Accounting for the model uncertainties, the probability that the annual surveillance is the optimal strategy in Singapore was 44.5%.
Endoscopic surveillance is potentially cost-effective in the prevention of GC for populations at low to intermediate risk. Regarding program implementation, a detailed analysis of influential factors and their associated thresholds is necessary. Multiple strategies should be considered in order to recommend the right strategy for the right population.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0083959</identifier><identifier>PMID: 24386314</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Age Distribution ; Aged ; Cancer ; Computer simulation ; Cost analysis ; Cost benefit analysis ; Economic aspects ; Endoscopes ; Endoscopy ; Endoscopy - economics ; Epidemiological Monitoring ; Expected values ; Female ; Gastric cancer ; Health care ; Health risks ; Health surveillance ; Helicobacter pylori ; Humans ; Male ; Markov chains ; Markov processes ; Medical screening ; Medicine ; Middle Aged ; Parameter identification ; Parameter uncertainty ; Pharmacy ; Populations ; Prevention ; Probability ; Public health ; Risk ; Screening ; Sensitivity analysis ; Sex Distribution ; Social and Behavioral Sciences ; Statistical analysis ; Stomach cancer ; Stomach Neoplasms - diagnosis ; Stomach Neoplasms - epidemiology ; Stomach Neoplasms - prevention & control ; Strategy ; Studies ; Subgroups ; Surveillance ; Thresholds</subject><ispartof>PloS one, 2013-12, Vol.8 (12), p.e83959-e83959</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Zhou et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Zhou et al 2013 Zhou et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-2af9015454d33a8074308335833e589eb12f6ab6c30a3e1aba4810ac3947f01a3</citedby><cites>FETCH-LOGICAL-c725t-2af9015454d33a8074308335833e589eb12f6ab6c30a3e1aba4810ac3947f01a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3873968/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3873968/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24386314$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Suzuki, Hiromu</contributor><creatorcontrib>Zhou, Hui Jun</creatorcontrib><creatorcontrib>Dan, Yock Young</creatorcontrib><creatorcontrib>Naidoo, Nasheen</creatorcontrib><creatorcontrib>Li, Shu Chuen</creatorcontrib><creatorcontrib>Yeoh, Khay Guan</creatorcontrib><title>A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Gastric cancer (GC) surveillance based on oesophagogastroduodenoscopy (OGD) appears to be a promising strategy for GC prevention. By evaluating the cost-effectiveness of endoscopic surveillance in Singaporean Chinese, this study aimed to inform the implementation of such a program in a population with a low to intermediate GC risk.
USING A REFERENCE STRATEGY OF NO OGD INTERVENTION, WE EVALUATED FOUR STRATEGIES: 2-yearly OGD surveillance, annual OGD surveillance, 2-yearly OGD screening and 2-yearly screening plus annual surveillance in Singaporean Chinese aged 50-69 years. From a perspective of the healthcare system, Markov models were built to simulate the life experience of the target population. The models projected discounted lifetime costs ($), quality adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER) indicating the cost-effectiveness of each strategy against a Singapore willingness-to-pay of $46,200/QALY. Deterministic and probabilistic sensitivity analyses were used to identify the influential variables and their associated thresholds, and to quantify the influence of parameter uncertainties respectively.
With an ICER of $44,098/QALY, the annual OGD surveillance was the optimal strategy while the 2-yearly surveillance was the most cost-effective strategy (ICER = $25,949/QALY). The screening-based strategies were either extendedly dominated or cost-ineffective. The cost-effectiveness heterogeneity of the four strategies was observed across age-gender subgroups. Eight influential parameters were identified each with their specific thresholds to define the choice of optimal strategy. Accounting for the model uncertainties, the probability that the annual surveillance is the optimal strategy in Singapore was 44.5%.
Endoscopic surveillance is potentially cost-effective in the prevention of GC for populations at low to intermediate risk. Regarding program implementation, a detailed analysis of influential factors and their associated thresholds is necessary. Multiple strategies should be considered in order to recommend the right strategy for the right population.</description><subject>Age</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Cancer</subject><subject>Computer simulation</subject><subject>Cost analysis</subject><subject>Cost benefit analysis</subject><subject>Economic aspects</subject><subject>Endoscopes</subject><subject>Endoscopy</subject><subject>Endoscopy - economics</subject><subject>Epidemiological Monitoring</subject><subject>Expected values</subject><subject>Female</subject><subject>Gastric cancer</subject><subject>Health care</subject><subject>Health risks</subject><subject>Health surveillance</subject><subject>Helicobacter pylori</subject><subject>Humans</subject><subject>Male</subject><subject>Markov chains</subject><subject>Markov processes</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Parameter identification</subject><subject>Parameter uncertainty</subject><subject>Pharmacy</subject><subject>Populations</subject><subject>Prevention</subject><subject>Probability</subject><subject>Public health</subject><subject>Risk</subject><subject>Screening</subject><subject>Sensitivity analysis</subject><subject>Sex Distribution</subject><subject>Social and Behavioral Sciences</subject><subject>Statistical analysis</subject><subject>Stomach cancer</subject><subject>Stomach Neoplasms - diagnosis</subject><subject>Stomach Neoplasms - epidemiology</subject><subject>Stomach Neoplasms - prevention & control</subject><subject>Strategy</subject><subject>Studies</subject><subject>Subgroups</subject><subject>Surveillance</subject><subject>Thresholds</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9-L1DAQx4so3nn6H4gWBNGHXZMm_ZEXYTn8sXBw4K_XME2n3Zzdpibpnvfof2662zu2cg8SQsLkM9_JTDJR9JySJWU5fXdlBttBu-xNh0tCCiZS8SA6pYIliywh7OHR_iR64twVISkrsuxxdJLwsGGUn0Z_VrEyzi-wrlF5vcMOnYshCN847WLcQTuA110TY1cZp0yvVewGu0PdttApjGtj4wact-FAjRa7N_WmH9rgaToXX2u_iVtzHXsT686j3WKlwWNstfv5NHpUQ-vw2bSeRd8_fvh2_nlxcflpfb66WKg8Sf0igVoQmvKUV4xBQXLOQs4sDRPTQmBJkzqDMlOMAEMKJfCCElBM8LwmFNhZ9PKg27fGyal6TlKeU8JTIWgg1geiMnAle6u3YG-kAS33BmMbCdZr1aLEjGaloIIWkHKWq3C5GnhSFgnNKgJ50Ho_RRvKkK3CzltoZ6Lzk05vZGN2khU5E1kRBN5MAtb8GtB5udVO4Vh0NMN4b0Gy8OTpGOvVP-j92U1UAyEB3dUmxFWjqFzxPBdFkjARqOU9VBgVbrUKX63WwT5zeDtzCIzH376BwTm5_vrl_9nLH3P29RG7QWj9xpl22P-oOcgPoLLGOYv1XZEpkWOn3FZDjp0ip04Jbi-OH-jO6bY12F-OKhAC</recordid><startdate>20131227</startdate><enddate>20131227</enddate><creator>Zhou, Hui Jun</creator><creator>Dan, Yock Young</creator><creator>Naidoo, Nasheen</creator><creator>Li, Shu Chuen</creator><creator>Yeoh, Khay Guan</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20131227</creationdate><title>A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk</title><author>Zhou, Hui Jun ; Dan, Yock Young ; Naidoo, Nasheen ; Li, Shu Chuen ; Yeoh, Khay Guan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-2af9015454d33a8074308335833e589eb12f6ab6c30a3e1aba4810ac3947f01a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Cancer</topic><topic>Computer simulation</topic><topic>Cost analysis</topic><topic>Cost benefit analysis</topic><topic>Economic aspects</topic><topic>Endoscopes</topic><topic>Endoscopy</topic><topic>Endoscopy - economics</topic><topic>Epidemiological Monitoring</topic><topic>Expected values</topic><topic>Female</topic><topic>Gastric cancer</topic><topic>Health care</topic><topic>Health risks</topic><topic>Health surveillance</topic><topic>Helicobacter pylori</topic><topic>Humans</topic><topic>Male</topic><topic>Markov chains</topic><topic>Markov processes</topic><topic>Medical screening</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Parameter identification</topic><topic>Parameter uncertainty</topic><topic>Pharmacy</topic><topic>Populations</topic><topic>Prevention</topic><topic>Probability</topic><topic>Public health</topic><topic>Risk</topic><topic>Screening</topic><topic>Sensitivity analysis</topic><topic>Sex Distribution</topic><topic>Social and Behavioral Sciences</topic><topic>Statistical analysis</topic><topic>Stomach cancer</topic><topic>Stomach Neoplasms - diagnosis</topic><topic>Stomach Neoplasms - epidemiology</topic><topic>Stomach Neoplasms - prevention & control</topic><topic>Strategy</topic><topic>Studies</topic><topic>Subgroups</topic><topic>Surveillance</topic><topic>Thresholds</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Hui Jun</creatorcontrib><creatorcontrib>Dan, Yock Young</creatorcontrib><creatorcontrib>Naidoo, Nasheen</creatorcontrib><creatorcontrib>Li, Shu Chuen</creatorcontrib><creatorcontrib>Yeoh, Khay Guan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale in Context : Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Hui Jun</au><au>Dan, Yock Young</au><au>Naidoo, Nasheen</au><au>Li, Shu Chuen</au><au>Yeoh, Khay Guan</au><au>Suzuki, Hiromu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-12-27</date><risdate>2013</risdate><volume>8</volume><issue>12</issue><spage>e83959</spage><epage>e83959</epage><pages>e83959-e83959</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Gastric cancer (GC) surveillance based on oesophagogastroduodenoscopy (OGD) appears to be a promising strategy for GC prevention. By evaluating the cost-effectiveness of endoscopic surveillance in Singaporean Chinese, this study aimed to inform the implementation of such a program in a population with a low to intermediate GC risk.
USING A REFERENCE STRATEGY OF NO OGD INTERVENTION, WE EVALUATED FOUR STRATEGIES: 2-yearly OGD surveillance, annual OGD surveillance, 2-yearly OGD screening and 2-yearly screening plus annual surveillance in Singaporean Chinese aged 50-69 years. From a perspective of the healthcare system, Markov models were built to simulate the life experience of the target population. The models projected discounted lifetime costs ($), quality adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER) indicating the cost-effectiveness of each strategy against a Singapore willingness-to-pay of $46,200/QALY. Deterministic and probabilistic sensitivity analyses were used to identify the influential variables and their associated thresholds, and to quantify the influence of parameter uncertainties respectively.
With an ICER of $44,098/QALY, the annual OGD surveillance was the optimal strategy while the 2-yearly surveillance was the most cost-effective strategy (ICER = $25,949/QALY). The screening-based strategies were either extendedly dominated or cost-ineffective. The cost-effectiveness heterogeneity of the four strategies was observed across age-gender subgroups. Eight influential parameters were identified each with their specific thresholds to define the choice of optimal strategy. Accounting for the model uncertainties, the probability that the annual surveillance is the optimal strategy in Singapore was 44.5%.
Endoscopic surveillance is potentially cost-effective in the prevention of GC for populations at low to intermediate risk. Regarding program implementation, a detailed analysis of influential factors and their associated thresholds is necessary. Multiple strategies should be considered in order to recommend the right strategy for the right population.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24386314</pmid><doi>10.1371/journal.pone.0083959</doi><tpages>e83959</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Age Distribution Aged Cancer Computer simulation Cost analysis Cost benefit analysis Economic aspects Endoscopes Endoscopy Endoscopy - economics Epidemiological Monitoring Expected values Female Gastric cancer Health care Health risks Health surveillance Helicobacter pylori Humans Male Markov chains Markov processes Medical screening Medicine Middle Aged Parameter identification Parameter uncertainty Pharmacy Populations Prevention Probability Public health Risk Screening Sensitivity analysis Sex Distribution Social and Behavioral Sciences Statistical analysis Stomach cancer Stomach Neoplasms - diagnosis Stomach Neoplasms - epidemiology Stomach Neoplasms - prevention & control Strategy Studies Subgroups Surveillance Thresholds |
| title | A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T12%3A04%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20cost-effectiveness%20analysis%20evaluating%20endoscopic%20surveillance%20for%20gastric%20cancer%20for%20populations%20with%20low%20to%20intermediate%20risk&rft.jtitle=PloS%20one&rft.au=Zhou,%20Hui%20Jun&rft.date=2013-12-27&rft.volume=8&rft.issue=12&rft.spage=e83959&rft.epage=e83959&rft.pages=e83959-e83959&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0083959&rft_dat=%3Cgale_plos_%3EA477982239%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1471045991&rft_id=info:pmid/24386314&rft_galeid=A477982239&rft_doaj_id=oai_doaj_org_article_e616b91918a5437caf9fa42b8216d0a7&rfr_iscdi=true |