oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
A decision support model for cost-effectiveness of radical prostatectomy in localized prostate cancer
Department of Biomedical Engineering, Division of Medical Informatics, Linköping University, Linköping, Sweden; Regional Cancer Center Southeast, Linköping University, Linköping, Sweden.
Department of Urology, Örebro University Hospital, Örebro, Sweden.
Department of Urology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Urology, Örebro University Hospital, Örebro, Sweden.
Show others and affiliations
2012 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 46, no 1, p. 19-25Article in journal (Refereed) Published
Abstract [en]

Objective: This study aimed to develop a probabilistic decision support model to calculate the lifetime incremental cost-effectiveness ratio (ICER) between radical prostatectomy and watchful waiting for different patient groups.

Material and methods: A randomized trial (SPCG-4) provided most data for this study. Data on survival, costs and quality of life were inputs in a decision analysis, and a decision support model was developed. The model can generate cost-effectiveness information on subgroups of patients with different characteristics.

Results: Age was the most important independent factor explaining cost-effectiveness. The cost-effectiveness value varied from 21,026 Swedish kronor (SEK) to 858,703 SEK for those aged 65 to 75 years, depending on Gleason scores and prostate-specific antigen (PSA) values. Information from the decision support model can support decision makers in judging whether or not radical prostatectomy (RP) should be used to treat a specific patient group.

Conclusions: The cost-effectiveness ratio for RP varies with age, Gleason scores, and PSA values. Assuming a threshold value of 200,000 SEK per quality-adjusted life-year (QALY) gained, for patients aged ≤70 years the treatment was always cost-effective, except at age 70, Gleason 0-4 and PSA ≤10. Using the same threshold value at age 75, Gleason 7-9 (regardless of PSA) and Gleason 5-6 (with PSA >20) were cost-effective. Hence, RP was not perceived to be cost-effective in men aged 75 years with low Gleason and low PSA. Higher threshold values for patients with clinically localized prostate cancer could be discussed

Place, publisher, year, edition, pages
London, United Kingdom: Informa Healthcare, 2012. Vol. 46, no 1, p. 19-25
Keywords [en]
Cost-effectiveness, decision support, prostate cancer, radical prostatectomy, randomized trial, watchful waiting
National Category
Medical and Health Sciences Urology and Nephrology
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27448DOI: 10.3109/00365599.2011.615759ISI: 000299125800005PubMedID: 21905981Scopus ID: 2-s2.0-84856187697OAI: oai:DiVA.org:oru-27448DiVA, id: diva2:603753
Available from: 2013-02-06 Created: 2013-02-06 Last updated: 2017-12-06Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Andersson, Swen-OlofAndrén, OveJohansson, Jan-Erik

Search in DiVA

By author/editor
Andersson, Swen-OlofAndrén, OveJohansson, Jan-Erik
By organisation
School of Health and Medical Sciences, Örebro University, Sweden
In the same journal
Scandinavian Journal of Urology and Nephrology
Medical and Health SciencesUrology and Nephrology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 86 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf