Cost-Efficacy of Endoscopic Ultrasonography with Fine-Needle Aspiration vs. Mediastinotomy in Patients with Lung Cancer and Suspected Mediastinal Adenopathy
The use of endoscopic ultrasonography (EUS) guidance for fine-needle aspiration (FNA) of mediastinal lymph nodes has become an important aid in the staging of bronchogenic carcinoma. In many cases, it may be an alternative to mediastinoscopy/mediastinotomy (MED), but the cost-effectiveness of the tw...
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| Veröffentlicht in: | Endoscopy 1999-11, Vol.31 (9), p.707-711 |
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| creator | Aabakken, L. Silvestri, G. A. Hawes, R. Reed, C. E. Marsi, V. Hoffman, B. |
| description | The use of endoscopic ultrasonography (EUS) guidance for fine-needle aspiration (FNA) of mediastinal lymph nodes has become an important aid in the staging of bronchogenic carcinoma. In many cases, it may be an alternative to mediastinoscopy/mediastinotomy (MED), but the cost-effectiveness of the two techniques has not been compared. The aim of this study was to apply a decision-analysis model to compare the cost-effectiveness of EUS and MED in the preoperative staging of patients with non-small-cell lung cancer.
A decision-analysis model was designed, taking as entry criteria lung cancer and abnormal mediastinal lymph nodes verified by computerized tomography (CT). Performance characteristics of MED and EUS were retrieved from the published literature, as were life expectancy data. Direct actual costs of the relevant procedures were retrieved from the billing system of our hospital.
The cost per year of expected survival is US$ 1.729 with the EUS strategy, and US$ 2.411 with the MED strategy. The advantage conferred by EUS remains even when the negative predictive value of EUS is as low as 0.22.
Because of its low cost and high yield, EUS-guided FNA is a cost-effective aid assessing mediastinal lymphadenopathy. |
| doi_str_mv | 10.1055/s-1999-74 |
| format | Article |
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A decision-analysis model was designed, taking as entry criteria lung cancer and abnormal mediastinal lymph nodes verified by computerized tomography (CT). Performance characteristics of MED and EUS were retrieved from the published literature, as were life expectancy data. Direct actual costs of the relevant procedures were retrieved from the billing system of our hospital.
The cost per year of expected survival is US$ 1.729 with the EUS strategy, and US$ 2.411 with the MED strategy. The advantage conferred by EUS remains even when the negative predictive value of EUS is as low as 0.22.
Because of its low cost and high yield, EUS-guided FNA is a cost-effective aid assessing mediastinal lymphadenopathy.</description><identifier>ISSN: 0013-726X</identifier><identifier>EISSN: 1438-8812</identifier><identifier>DOI: 10.1055/s-1999-74</identifier><identifier>PMID: 10604611</identifier><identifier>CODEN: ENDCAM</identifier><language>eng</language><publisher>Stuttgart: Thieme</publisher><subject>Biological and medical sciences ; Biopsy, Needle - economics ; Bronchoscopy ; Carcinoma, Bronchogenic - economics ; Carcinoma, Bronchogenic - pathology ; Carcinoma, Non-Small-Cell Lung - economics ; Carcinoma, Non-Small-Cell Lung - pathology ; Cost-Benefit Analysis ; Decision Support Techniques ; Endoscopy ; Endosonography - economics ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Lung Neoplasms - economics ; Lung Neoplasms - pathology ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Mediastinoscopy - economics ; Medical sciences ; Neoplasm Staging ; Original Article ; Predictive Value of Tests</subject><ispartof>Endoscopy, 1999-11, Vol.31 (9), p.707-711</ispartof><rights>Georg Thieme Verlag Stuttgart ·New York</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-98edc963087186b618a90f2846ac5fcbc1ac57659bde11329c07ec16043cf2923</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-1999-74.pdf$$EPDF$$P50$$Gthieme$$H</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1055/s-1999-74$$EHTML$$P50$$Gthieme$$H</linktohtml><link.rule.ids>314,776,780,3004,3005,27901,27902,54534,54535</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1192745$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10604611$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aabakken, L.</creatorcontrib><creatorcontrib>Silvestri, G. A.</creatorcontrib><creatorcontrib>Hawes, R.</creatorcontrib><creatorcontrib>Reed, C. E.</creatorcontrib><creatorcontrib>Marsi, V.</creatorcontrib><creatorcontrib>Hoffman, B.</creatorcontrib><title>Cost-Efficacy of Endoscopic Ultrasonography with Fine-Needle Aspiration vs. Mediastinotomy in Patients with Lung Cancer and Suspected Mediastinal Adenopathy</title><title>Endoscopy</title><addtitle>Endoscopy</addtitle><description>The use of endoscopic ultrasonography (EUS) guidance for fine-needle aspiration (FNA) of mediastinal lymph nodes has become an important aid in the staging of bronchogenic carcinoma. In many cases, it may be an alternative to mediastinoscopy/mediastinotomy (MED), but the cost-effectiveness of the two techniques has not been compared. The aim of this study was to apply a decision-analysis model to compare the cost-effectiveness of EUS and MED in the preoperative staging of patients with non-small-cell lung cancer.
A decision-analysis model was designed, taking as entry criteria lung cancer and abnormal mediastinal lymph nodes verified by computerized tomography (CT). Performance characteristics of MED and EUS were retrieved from the published literature, as were life expectancy data. Direct actual costs of the relevant procedures were retrieved from the billing system of our hospital.
The cost per year of expected survival is US$ 1.729 with the EUS strategy, and US$ 2.411 with the MED strategy. The advantage conferred by EUS remains even when the negative predictive value of EUS is as low as 0.22.
Because of its low cost and high yield, EUS-guided FNA is a cost-effective aid assessing mediastinal lymphadenopathy.</description><subject>Biological and medical sciences</subject><subject>Biopsy, Needle - economics</subject><subject>Bronchoscopy</subject><subject>Carcinoma, Bronchogenic - economics</subject><subject>Carcinoma, Bronchogenic - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - economics</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Cost-Benefit Analysis</subject><subject>Decision Support Techniques</subject><subject>Endoscopy</subject><subject>Endosonography - economics</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Lung Neoplasms - economics</subject><subject>Lung Neoplasms - pathology</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Mediastinoscopy - economics</subject><subject>Medical sciences</subject><subject>Neoplasm Staging</subject><subject>Original Article</subject><subject>Predictive Value of Tests</subject><issn>0013-726X</issn><issn>1438-8812</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0cFu1DAQBmALgehSOPACyAeE4JBiO4kTH1erLVRaChJU4hZ5nUnXVWKnHgeUd-nD4lVWag-cRiN_M5b-IeQtZxecleVnzLhSKquKZ2TFi7zO6pqL52TFGM-zSsjfZ-QV4t2xZax8Sc44k6yQnK_Iw8ZjzLZdZ402M_Ud3brWo_GjNfSmj0Gjd_426PEw0782HuildZBdA7Q90DWONuhovaN_8IJ-g9ZqjNb56IeZWkd_pEdwEZfR3eRu6UY7A4Fq19KfE45gIrSPk7qn6xacH3U8zK_Ji073CG9O9ZzcXG5_bb5mu-9frjbrXWbySsRM1dAaJXNWV7yWe8lrrVgn6kJqU3Zmb3iqlSzVvgXOc6EMq8DwFEFuOqFEfk4-LHvH4O8nwNgMFg30vXbgJ2ykyksphEzw0wJN8IgBumYMdtBhbjhrjqdosDmeoqmKZN-dlk77Adoncsk-gfcnoNHovgspGIuPjitRFWViHxcWDxYGaO78FFJM-J8v_wFXuKAO</recordid><startdate>19991101</startdate><enddate>19991101</enddate><creator>Aabakken, L.</creator><creator>Silvestri, G. 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E. ; Marsi, V. ; Hoffman, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-98edc963087186b618a90f2846ac5fcbc1ac57659bde11329c07ec16043cf2923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Biological and medical sciences</topic><topic>Biopsy, Needle - economics</topic><topic>Bronchoscopy</topic><topic>Carcinoma, Bronchogenic - economics</topic><topic>Carcinoma, Bronchogenic - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - economics</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Cost-Benefit Analysis</topic><topic>Decision Support Techniques</topic><topic>Endoscopy</topic><topic>Endosonography - economics</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Lung Neoplasms - economics</topic><topic>Lung Neoplasms - pathology</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis</topic><topic>Mediastinoscopy - economics</topic><topic>Medical sciences</topic><topic>Neoplasm Staging</topic><topic>Original Article</topic><topic>Predictive Value of Tests</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aabakken, L.</creatorcontrib><creatorcontrib>Silvestri, G. A.</creatorcontrib><creatorcontrib>Hawes, R.</creatorcontrib><creatorcontrib>Reed, C. E.</creatorcontrib><creatorcontrib>Marsi, V.</creatorcontrib><creatorcontrib>Hoffman, B.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aabakken, L.</au><au>Silvestri, G. A.</au><au>Hawes, R.</au><au>Reed, C. E.</au><au>Marsi, V.</au><au>Hoffman, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-Efficacy of Endoscopic Ultrasonography with Fine-Needle Aspiration vs. Mediastinotomy in Patients with Lung Cancer and Suspected Mediastinal Adenopathy</atitle><jtitle>Endoscopy</jtitle><addtitle>Endoscopy</addtitle><date>1999-11-01</date><risdate>1999</risdate><volume>31</volume><issue>9</issue><spage>707</spage><epage>711</epage><pages>707-711</pages><issn>0013-726X</issn><eissn>1438-8812</eissn><coden>ENDCAM</coden><abstract>The use of endoscopic ultrasonography (EUS) guidance for fine-needle aspiration (FNA) of mediastinal lymph nodes has become an important aid in the staging of bronchogenic carcinoma. In many cases, it may be an alternative to mediastinoscopy/mediastinotomy (MED), but the cost-effectiveness of the two techniques has not been compared. The aim of this study was to apply a decision-analysis model to compare the cost-effectiveness of EUS and MED in the preoperative staging of patients with non-small-cell lung cancer.
A decision-analysis model was designed, taking as entry criteria lung cancer and abnormal mediastinal lymph nodes verified by computerized tomography (CT). Performance characteristics of MED and EUS were retrieved from the published literature, as were life expectancy data. Direct actual costs of the relevant procedures were retrieved from the billing system of our hospital.
The cost per year of expected survival is US$ 1.729 with the EUS strategy, and US$ 2.411 with the MED strategy. The advantage conferred by EUS remains even when the negative predictive value of EUS is as low as 0.22.
Because of its low cost and high yield, EUS-guided FNA is a cost-effective aid assessing mediastinal lymphadenopathy.</abstract><cop>Stuttgart</cop><cop>New York, NY</cop><pub>Thieme</pub><pmid>10604611</pmid><doi>10.1055/s-1999-74</doi><tpages>5</tpages></addata></record> |
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| subjects | Biological and medical sciences Biopsy, Needle - economics Bronchoscopy Carcinoma, Bronchogenic - economics Carcinoma, Bronchogenic - pathology Carcinoma, Non-Small-Cell Lung - economics Carcinoma, Non-Small-Cell Lung - pathology Cost-Benefit Analysis Decision Support Techniques Endoscopy Endosonography - economics Humans Investigative techniques, diagnostic techniques (general aspects) Lung Neoplasms - economics Lung Neoplasms - pathology Lymph Nodes - pathology Lymphatic Metastasis Mediastinoscopy - economics Medical sciences Neoplasm Staging Original Article Predictive Value of Tests |
| title | Cost-Efficacy of Endoscopic Ultrasonography with Fine-Needle Aspiration vs. Mediastinotomy in Patients with Lung Cancer and Suspected Mediastinal Adenopathy |
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