2016
DOI: 10.1016/j.brachy.2016.01.003
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Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing

Abstract: PURPOSE Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. METHODS AND MATERIALS Patients with low-risk PCa treated with low-dose rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement (ICHOM) standard set, which incl… Show more

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Cited by 37 publications
(27 citation statements)
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“…Finally, the additional costs of these strategies need to be assessed. Assuming there is a clinical benefit, adding serial MRI and prolonging operating room time would add costs that would need to be justified by improved clinical outcomes, especially knowing that the main driver of costs in prostate brachytherapy is the time spent in the operating room (48). The procedure duration has been shown to follow a learning curve and to decrease over time, leading to a decrease in operating room costs (22, 23).…”
Section: Discussionmentioning
confidence: 99%
“…Finally, the additional costs of these strategies need to be assessed. Assuming there is a clinical benefit, adding serial MRI and prolonging operating room time would add costs that would need to be justified by improved clinical outcomes, especially knowing that the main driver of costs in prostate brachytherapy is the time spent in the operating room (48). The procedure duration has been shown to follow a learning curve and to decrease over time, leading to a decrease in operating room costs (22, 23).…”
Section: Discussionmentioning
confidence: 99%
“…The minimal clinically important difference (MCID) was defined as half the standard deviation of the mean at baseline . Results are normalized to baseline and visualized using radar plots, with numbers <100 showing a decreased QoL compared with baseline and numbers >100 an improved QoL after treatment .…”
Section: Methodsmentioning
confidence: 99%
“…Reports from retrospective or registry series of favorable outcomes after prostate brachytherapy for men with intermediate-risk disease (3-7) have led to this treatment being included in clinical guidelines (8,9) and gradually implemented (10) for such patients. Even though permanent seed brachytherapy has been shown to have high value (11) and to result in comparable or better quality of life than other approved treatment options (12)(13)(14)(15)(16), especially with regard to urinary continence and sexual potency, the overall use of brachytherapy in the United States is decreasing as more patients are being treated with surgery or external beam radiation therapy or monitored with active surveillance (17)(18)(19). Reports of prospectively collected data would be helpful in assessing the outcomes and value of brachytherapy and in helping patients make informed treatment decisions.…”
Section: Introductionmentioning
confidence: 99%