Cost-effectiveness of diagnosis: tests, pay-offs and uncertainties

Abstract: The cost-effectiveness of diagnosis raises challenges in identifying the possible ways to combine tests, obtaining the pay-offs in terms of long-term outcomes and costs, and understanding uncertainty. We report our approach to these issues in the context of the cost-effectiveness of diagnosis of clinically significant prostate cancer. 

The cost-effectiveness analysis took 3 stages. First, we conceptualise and implement the diagnosis model to evaluate the different ways the tests can be used to diagnose a lesion as clinically significant cancer. Second, we obtain the long-term outcomes and costs from correct and incorrect diagnosis and subsequent management. Third, we evaluate and represent the uncertainty in the cost-effectiveness results. 

In this seminar, I will walk you through the cost-effectiveness analysis conducted for the PROMIS project, how we approached each of the stages, and insights for future research. Full details of the publication are below:

• Faria R, Soares MO, Spackman DE, Ahmed HU, Brown L, Kaplan R, Emberton M, Sculpher MJ. Optimising the diagnosis of prostate cancer in the era of multi-parametric magnetic resonance imaging: a cost-effectiveness analysis based on the PROMIS study: How to optimise the diagnosis of prostate cancer. European Urology 2018;73(1):23-30.