PMC:4636534 / 21480-24170 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/4636534","sourcedb":"PMC","sourceid":"4636534","source_url":"https://www.ncbi.nlm.nih.gov/pmc/4636534","text":"Interpretation of the results\nWhen interpreting the results of the model, total estimated costs of diagnostic test, treatments and health state are compared to estimate health outcome over the chosen period of time. Figure 4 graphically illustrates the costs versus effectiveness comparison. The imaging strategy that yields the highest number of QALYs is considered most effective. If a strategy is less costly and more effective, it is cost-effective and superior to the alternative strategy (Fig. 4d). If a strategy is more costly and less effective than its alternative, it is dominated by the alternative (Fig. 4a).\nFig. 4 Cost-effectiveness graph. QALY: Quality adjusted live years. ICER: Incremental cost-effectiveness ratio\nA decision-analytic perspective implies that for an imaging strategy to be adopted, it has to be cost-effective compared to its next best alternative [37]. In case the strategy is more costly and more effective, or less costly and less effective than the alternative (Fig. 4b,c), incremental cost-effectiveness ratios (ICERs) need to be calculated by dividing the incremental costs by the incremental QALYs. The decision whether the strategy is deemed cost-effective then depends on how much society is willing to pay for a QALY gained or lost. In the Netherlands, for example, the informal societal willingness to pay (WTP) threshold level is € 80,000 [38]. If in quadrant b the ICER is lower than this level, the strategy is cost-effective compared to the alternative (Fig. 4b). In quadrant c, the ICER needs to be higher than the WTP in order to be cost-effective. To illustrate the results of the probabilistic sensitivity analysis, cost-effectiveness acceptability curves (CEACs) can be calculated [39]. CEACs are shown in Fig. 5 demonstrating the probability that a strategy is cost-effective, given different values of willingness to pay for a QALY. This figure shows that if societal WTP for a QALY is low, conventional follow-up is certainly the most cost-effective strategy. If the willingness to pay increases, the probability that this is true decreases. At a willingness to pay of € 80,000 per QALY, PET-CT-based follow-up and conventional follow-up have a similar probability of being cost-effective of approximately 48 %. The probability that CT is cost-effective is only 5 %. This implies that, although it is uncertain which diagnostic test is most cost-effective, it is quite certain that it is not CT.\nFig. 5 Schematic example of cost-effectiveness acceptability curves (CEACs). The probability of cost-effectiveness of three investigated imaging tests is plotted against the willingness to pay for a quality adjusted life year (QALY) [6] ","divisions":[{"label":"title","span":{"begin":0,"end":29}},{"label":"p","span":{"begin":30,"end":731}},{"label":"figure","span":{"begin":621,"end":731}},{"label":"label","span":{"begin":621,"end":627}},{"label":"caption","span":{"begin":628,"end":731}},{"label":"p","span":{"begin":628,"end":731}},{"label":"label","span":{"begin":2453,"end":2459}}],"tracks":[{"project":"TEST0","denotations":[{"id":"26003789-151-157-67127","span":{"begin":883,"end":885},"obj":"[\"12241891\"]"},{"id":"26003789-136-142-67128","span":{"begin":1736,"end":1738},"obj":"[\"7827647\"]"},{"id":"26003789-157-162-67129","span":{"begin":2687,"end":2688},"obj":"[\"19944595\"]"}],"attributes":[{"subj":"26003789-151-157-67127","pred":"source","obj":"TEST0"},{"subj":"26003789-136-142-67128","pred":"source","obj":"TEST0"},{"subj":"26003789-157-162-67129","pred":"source","obj":"TEST0"}]},{"project":"0_colil","denotations":[{"id":"26003789-12241891-67127","span":{"begin":883,"end":885},"obj":"12241891"},{"id":"26003789-7827647-67128","span":{"begin":1736,"end":1738},"obj":"7827647"},{"id":"26003789-19944595-67129","span":{"begin":2687,"end":2688},"obj":"19944595"}],"attributes":[{"subj":"26003789-12241891-67127","pred":"source","obj":"0_colil"},{"subj":"26003789-7827647-67128","pred":"source","obj":"0_colil"},{"subj":"26003789-19944595-67129","pred":"source","obj":"0_colil"}]},{"project":"MyTest","denotations":[{"id":"26003789-12241891-29373370","span":{"begin":883,"end":885},"obj":"12241891"},{"id":"26003789-7827647-29373371","span":{"begin":1736,"end":1738},"obj":"7827647"},{"id":"26003789-19944595-29373372","span":{"begin":2687,"end":2688},"obj":"19944595"}],"namespaces":[{"prefix":"_base","uri":"https://www.uniprot.org/uniprot/testbase"},{"prefix":"UniProtKB","uri":"https://www.uniprot.org/uniprot/"},{"prefix":"uniprot","uri":"https://www.uniprot.org/uniprotkb/"}],"attributes":[{"subj":"26003789-12241891-29373370","pred":"source","obj":"MyTest"},{"subj":"26003789-7827647-29373371","pred":"source","obj":"MyTest"},{"subj":"26003789-19944595-29373372","pred":"source","obj":"MyTest"}]},{"project":"2_test","denotations":[{"id":"26003789-12241891-29373370","span":{"begin":883,"end":885},"obj":"12241891"},{"id":"26003789-7827647-29373371","span":{"begin":1736,"end":1738},"obj":"7827647"},{"id":"26003789-19944595-29373372","span":{"begin":2687,"end":2688},"obj":"19944595"}],"attributes":[{"subj":"26003789-12241891-29373370","pred":"source","obj":"2_test"},{"subj":"26003789-7827647-29373371","pred":"source","obj":"2_test"},{"subj":"26003789-19944595-29373372","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"TEST0","color":"#eccd93","default":true},{"id":"0_colil","color":"#b393ec"},{"id":"MyTest","color":"#93ec99"},{"id":"2_test","color":"#ec93a6"}]}]}}