Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0083959
Title: A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk
Authors: Zhou, H.J.
Dan, Y.Y.
Naidoo, N. 
Li, S.C.
Yeoh, K.G.
Issue Date: 27-Dec-2013
Citation: Zhou, H.J., Dan, Y.Y., Naidoo, N., Li, S.C., Yeoh, K.G. (2013-12-27). A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk. PLoS ONE 8 (12) : -. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0083959
Abstract: Background: 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. Methods: 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. Results: 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%. Conclusion: 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. © 2013 Zhou et al.
Source Title: PLoS ONE
URI: http://scholarbank.nus.edu.sg/handle/10635/108854
ISSN: 19326203
DOI: 10.1371/journal.pone.0083959
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
2013_A_cost-effectiveness_analysis_evaluating_endoscopic-published.PDF410.83 kBAdobe PDF

OPEN

PublishedView/Download

SCOPUSTM   
Citations

9
checked on Jun 14, 2018

WEB OF SCIENCETM
Citations

7
checked on May 1, 2018

Page view(s)

87
checked on May 4, 2018

Download(s)

12
checked on May 4, 2018

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.