Effects of Bladder Cancer on UK Healthcare Costs and Patient Health-Related Quality of Life: Evidence From the BOXIT Trial

Cox, Edward; Saramago, Pedro; Kelly, John D.; Porta, Núria; Hall, Emma; Tan, Wei Shen; Sculpher, Mark; Soares, Marta

doi:10.1016/j.clgc.2019.12.004

Cited by 33 publications

(34 citation statements)

References 41 publications

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“…In each case we use a common estimation model for costs and QALYs, and standard off-the-shelf software. Previous tutorial papers (1-3) compared case-analysis (CCA) (8)(9)(10), multiple Imputation (MI) (8,(10)(11)(12) and repeated measure mixed model (RMM) (13). This study extends this previous methodological work by including a Bayesian parametric approach using the R package missingHE (BPA) (14) and examining the results over different time horizons (and hence with different quantities of missing data) of 1, 3 and 5 years.…”

Section: Comparing Methods For Handling Missing Cost and Outcome Data In Clinical Trial-based Cost-effectiveness Analysis 1 Introductionmentioning

confidence: 86%

“…More complex error structures and functional forms are possible, (19)(20)(21)(22)(23)(24)(25) but are not explored here. RMM and related approaches such as Generalized Estimating Equations are widely used for unbalanced longitudinal data but, with few exceptions (13), have not been widely used for cost-effectiveness analysis.…”

Section: Comparing Methods For Handling Missing Cost and Outcome Data In Clinical Trial-based Cost-effectiveness Analysis 1 Introductionmentioning

confidence: 99%

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Comparing Methods for Handling Missing Cost and Outcome Data in Clinical Trial-based Cost-effectiveness Analysis

Diop

Epstein

2021

Preprint

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OBJECTIVES: This study compares methods for handling missing data to conduct cost-effectiveness analysis in the context of a clinical study.METHODS: A long-term clinical trial with staggered recruitment was used as a case study (EVRA, NIHR-HTA project 11/129/197). Patients had between 1 year and 5.5 years (median 3 years) of follow-up under “early” or “deferred” treatment. The methods compared were Complete-Case-Analysis (CCA), multiple imputation using linear regression (MILR) and using predictive mean matching (MIPMM), Bayesian parametric approach using the R package missingHE (BPA) and repeated measures mixed model (RMM). The outcomes were total mean costs and total mean quality-adjusted life years (QALYs) at different time horizons (1 year, 3 years and 5 years). RESULTS: All methods found no statistically significant difference in cost at the 5% level in all years, and all methods found statistically significantly greater mean QALY at year 1. At year 3, BPA showed a statistically significant difference while other method did not at later time horizons. Standard errors differed substantially between the methods employed. CONCLUSION: MIPMM seemed to perform better than MILM, confirming findings from simulation studies. RMM and BPA might be feasible options, though they did not perform better than MIPMM in this dataset. Further simulation studies and applications should continue to compare these methods.

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Section: Comparing Methods For Handling Missing Cost and Outcome Data In Clinical Trial-based Cost-effectiveness Analysis 1 Introductionmentioning

confidence: 86%

Section: Comparing Methods For Handling Missing Cost and Outcome Data In Clinical Trial-based Cost-effectiveness Analysis 1 Introductionmentioning

confidence: 99%

Comparing Methods for Handling Missing Cost and Outcome Data in Clinical Trial-based Cost-effectiveness Analysis

Diop

Epstein

2021

Preprint

View full text Add to dashboard Cite

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“…However, these findings are in contrast with the respective literature reports. In the BOXIT trial, patients with no NMIBC progression or recurrence reached a minimal EQ-5D score at 2 months postoperatively, with no further improvement (27). Similarly data from a multicenter prospective cohort trial reported a plateau in the SF-36 mental and physical scores throughout the study period (26).…”

Section: Discussionmentioning

confidence: 99%

Quality of life and anxiety in patients with non-muscle invasive bladder cancer: a prospective study

Vaioulis

Bonotis

Perivoliotis

et al. 2020

Preprint

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Introduction We evaluated anxiety and quality of life (QoL) in patients who were operated for non-muscle invasive bladder cancer (NMIBC) Methods The present study is a prospective analysis of patients with histopathologically confirmed NMIBCs after they were submitted to transurethral resection of the tumour (TURBT). Eligible were all adult patients with a single or multiple NMIBCs. All included patients followed therapy with either BCG or Epirubicin instillations. The SF-36 questionnaire Physical and Mental health aspects were used for QoL assessment. Similarly, the STAI-Y was introduced for the state (STAI-Y1) and trait anxiety (STAI-Y2) evaluation. Results In total, 117 eligible patients were included. Regarding SF-36 Physical a 6 months decrease was followed by an improvement at 12 months. Similarly, an increase of the SF-36 Mental health score was identified. In contrast to STAI-Y2, a long-term reduction of the state anxiety was identified. Preoperative SF-36 Physical was inversely correlated with age, while absence of alcohol was associated with lower mental health. Overall, patient characteristics, habits and the administered treatment did not affect the postoperative QoL and anxiety. Conclusions Patient QoL and anxiety improved during follow up. Although certain characteristics were related to QoL and anxiety, further larger scale studies are required.

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“…Following treatment for diagnosed bladder cancer, follow‐up by means of cystoscopic surveillance is required for many years. For non‐muscle‐invasive bladder cancer (NMIBC), the 3 year total costs per person for surveillance alone are estimated to be over £4500, with additional costs for any recurrence or progression 13 …”

Section: Introduction and Objectivesmentioning

confidence: 99%

“…For non-muscle-invasive bladder cancer (NMIBC), the 3 year total costs per person for surveillance alone are estimated to be over £4500, with additional costs for any recurrence or progression. 13 Risk grouping/stratifying models, probability nomograms, and artificial neural networks are all methods by which urologists have hoped to reduce the amount of unnecessary investigations that are performed and to help better focus resources on patients who truly require them. 14 However, these methods, no matter how much collective data are inputted, are generic and not patient specific, and will therefore result in some patients being incorrectly stratified.…”

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confidence: 99%

The role of URO17™ biomarker to enhance diagnosis of urothelial cancer in new hematuria patients—First European Data

et al. 2020

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Introduction and objectives Novel biomarker research is vital for the progression of safe and thorough diagnostic medicine. There is now a need to improve the diagnosis of bladder cancer via a noninvasive urine test while balancing the risks of harm from investigational procedures, such as cystoscopy and radiological tests, against the likelihood of malignancy. We evaluate the diagnostic accuracy and sensitivity of Uro17™ urinary biomarker for the detection of urothelial cancer in hematuria patients in a prospective blinded validation study. Uro17™ is an immunobiomarker which binds to the oncoprotein Keratin 17, which is involved in the replication cycle of malignant cells. This study compared cystoscopic and histological investigations against Uro17™ results in patients being investigated for symptoms of urothelial cancer. Materials and methods After receiving both local and national ethics/protocol approval, 71 patients were consented and recruited into the study. All patients were scheduled to undergo cystoscopic investigation, and following recruitment, a urine sample was collected. Urine samples were anonymized and processed as per standard cytology protocols and stained using Uro17™ immunobiomarker. The pathologists assessing the results were blinded to the patient and background history, and the results were compared to the biopsy histology. Results The full cohort of enrolled patients consisted of 71 participants included. There were 55 males and 16 females, with an average age of 70. Thirteen were current smokers, 42 ex‐smokers, and 16 nonsmokers. The malignancies detected included both muscle‐invasive (n = 6) and non‐muscle‐invasive tumors (n = 38), and tumors of all grades and carcinoma in situ. Uro17™ was shown to have an overall sensitivity of 100% and a specificity of 92.6%, with a positive predictive value of 0.957 and negative predictive value of 1. Uro17™ investigation was positive in every case of urothelial malignancy. Conclusions Our current data indicates Uro17™ is a highly sensitive noninvasive bladder cancer urine detection test that can improve the diagnosis of Bladder cancer. This can further improve diagnostic capabilities in primary care, reduce the number of referrals to Urology department, and reduce the number of unnecessary invasive procedures for new patients with a suspected urinary bladder cancer.

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Effects of Bladder Cancer on UK Healthcare Costs and Patient Health-Related Quality of Life: Evidence From the BOXIT Trial

Cited by 33 publications

References 41 publications

Comparing Methods for Handling Missing Cost and Outcome Data in Clinical Trial-based Cost-effectiveness Analysis

Comparing Methods for Handling Missing Cost and Outcome Data in Clinical Trial-based Cost-effectiveness Analysis

Quality of life and anxiety in patients with non-muscle invasive bladder cancer: a prospective study

The role of URO17™ biomarker to enhance diagnosis of urothelial cancer in new hematuria patients—First European Data

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