Cost-effectiveness and resource use of implementing MRI-guided NACT in ER-positive/HER2-negative breast cancers in The Netherlands

Miquel-Cases, Anna; Steuten, Lotte Maria Gertruda; Rigter, Lisanne S.; Harten, Wim H. van

doi:10.1186/s12885-016-2653-y

Cited by 3 publications

(2 citation statements)

References 43 publications

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“…Finally, besides standardization and validation issues, there are also limited data about the cost-effectiveness of MRI in the NST setting [ 63 ]. To get an overall idea of the added value of DWI in this NST setting, also cost-effectiveness needs to be analyzed.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the value of diffusion-weighted imaging for identifying breast cancer patients with pathological complete response on neoadjuvant systemic therapy: a systematic review

et al. 2021

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This review aims to identify factors causing heterogeneity in breast DWI–MRI and their impact on its value for identifying breast cancer patients with pathological complete response (pCR) on neoadjuvant systemic therapy (NST). A search was performed on PubMed until April 2020 for studies analyzing DWI for identifying breast cancer patients with pCR on NST. Technical and clinical study aspects were extracted and assessed for variability. Twenty studies representing 1455 patients/lesions were included. The studies differed with respect to study population, treatment type, DWI acquisition technique, post-processing (e.g., mono-exponential/intravoxel incoherent motion/stretched exponential modeling), and timing of follow-up studies. For the acquisition and generation of ADC-maps, various b-value combinations were used. Approaches for drawing regions of interest on longitudinal MRIs were highly variable. Biological variability due to various molecular subtypes was usually not taken into account. Moreover, definitions of pCR varied. The individual areas under the curve for the studies range from 0.50 to 0.92. However, overlapping ranges of mean/median ADC-values at pre- and/or during and/or post-NST were found for the pCR and non-pCR groups between studies. The technical, clinical, and epidemiological heterogeneity may be causal for the observed variability in the ability of DWI to predict pCR accurately. This makes implementation of DWI for pCR prediction and evaluation based on one absolute ADC threshold for all breast cancer types undesirable. Multidisciplinary consensus and appropriate clinical study design, taking biological and therapeutic variation into account, is required for obtaining standardized, reliable, and reproducible DWI measurements for pCR/non-pCR identification.

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Section: Discussionmentioning

confidence: 99%

Factors affecting the value of diffusion-weighted imaging for identifying breast cancer patients with pathological complete response on neoadjuvant systemic therapy: a systematic review

et al. 2021

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“…It should be noted that DES modelling is not a prerequisite for capturing the effect of constraints via throughput measuresapproaches that predominate in HTA such as cohort-based state transition models (such as Markov models) and decision tree models can be used for estimating overall resource requirements. Two such studies reported the use of Markov modelling to estimate the resources required in order to estimate the feasibility of the respective programmes [41,42].…”

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confidence: 99%

Discrete Event Simulation-Based Resource Modelling in Health Technology Assessment

et al. 2017

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OBJECTIVE:To conduct a systematic review of published research on the use of discrete event simulation (DES) for resource modelling in health technology assessment (HTA). Resource modelling (RM) is broadly defined as incorporating and measuring effects of constraints on physical resources (e.g. beds, doctors, nurses) in HTA models. METHODS: Systematic literature searches were conducted in academic databases (JSTOR, SAGE, SPRINGER, SCOPUS, IEEE, Science Direct, PUBMED, EMBASE) and grey literature (Google Scholar, NHS journal library), enhanced by manual searchers (i.e. reference list checking, citation searching and hand searching techniques). RESULTS:The search strategy yielded 4,117 potentially relevant citations. Following the screening and manual searches, 10 articles were included. Reviewing these articles provided insights into the applications of RM: firstly, different types of economic analyses, model settings, RM and costeffectiveness analysis (CEA) outcomes were identified. Secondly, variation in the characteristics of the constraints such as types and nature of constraints, sources of data for the constraints were identified. Thirdly, it was found that including the effects of constraints caused the CEA results to change in these articles. CONCLUSION:The review found that DES proved to be an effective technique for RM but there were only a small number of studies applied in HTA. However, these studies showed the important consequences of modelling physical constraints and point to the need for a framework to be developed to guide future applications of this approach. (230 words) Keywords Discrete event simulation, resource modelling, health technology assessment, simulation modelling 2 Key Points for Decision Makers  Economic evaluation studies in health care typically ignore the short-term constraints on physical resources (e.g. doctors, nurses) which can lead to incorrect results.  Discrete Event Simulation is an effective tool for modelling the effects of constraints but there were only a small number of studies applied in health technology assessment (HTA).  Further research is required to examine the possible developments for detailed modelling of the resource constraints in HTA.

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Incorporating Resource Constraints in Health Economic Evaluations: Overview and Methodological Considerations

Thokala,

Duarte,

Wright

et al. 2024

PharmacoEconomics Open

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Cost-effectiveness and resource use of implementing MRI-guided NACT in ER-positive/HER2-negative breast cancers in The Netherlands

Cited by 3 publications

References 43 publications

Factors affecting the value of diffusion-weighted imaging for identifying breast cancer patients with pathological complete response on neoadjuvant systemic therapy: a systematic review

Factors affecting the value of diffusion-weighted imaging for identifying breast cancer patients with pathological complete response on neoadjuvant systemic therapy: a systematic review

Discrete Event Simulation-Based Resource Modelling in Health Technology Assessment

Incorporating Resource Constraints in Health Economic Evaluations: Overview and Methodological Considerations

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