Wide Area Transepithelial Sampling with Computer-Assisted Analysis (WATS3D) Is Cost-Effective in Barrett's Esophagus Screening.
Dig Dis Sci
; 66(5): 1572-1579, 2021 05.
Article
em En
| MEDLINE
| ID: mdl-32578042
ABSTRACT
BACKGROUND:
Wide area transepithelial sampling with three-dimensional computer-assisted analysis (WATS3D) is an adjunct to the standard random 4-quadrant forceps biopsies (FB, "Seattle protocol") that significantly increases the detection of Barrett's esophagus (BE) and associated neoplasia in patients undergoing screening or surveillance.AIMS:
To examine the cost-effectiveness of adding WATS3D to the Seattle protocol in screening patients for BE.METHODS:
A decision analytic model was used to compare the effectiveness and cost-effectiveness of two alternative BE screening strategies in chronic gastroesophageal reflux disease patients FB with and without WATS3D. The reference case was a 60-year-old white male with gastroesophageal reflux disease (GERD). Effectiveness was measured by the number needed to screen to avert one cancer and one cancer-related death, and quality-adjusted life years (QALYs). Cost was measured in 2019 US$, and the incremental cost-effectiveness ratio (ICER) was measured in $/QALY using thresholds for cost-effectiveness of $100,000/QALY and $150,000/QALY. Cost was measured in 2019 US$. Cost and QALYs were discounted at 3% per year.RESULTS:
Between 320 and 337 people would need to be screened with WATS3D in addition to FB to avert one additional cancer, and 328-367 people to avert one cancer-related death. Screening with WATS3D costs an additional $1219 and produced an additional 0.017 QALYs, for an ICER of $71,395/QALY. All one-way sensitivity analyses resulted in ICERs under $84,000/QALY.CONCLUSIONS:
Screening for BE in 60-year-old white male GERD patients is more cost-effective when WATS3D is used adjunctively to the Seattle protocol than with the Seattle protocol alone.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Esôfago de Barrett
/
Neoplasias Esofágicas
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Refluxo Gastroesofágico
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Diagnóstico por Computador
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Custos de Cuidados de Saúde
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Células Epiteliais
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Detecção Precoce de Câncer
/
Mucosa Esofágica
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
/
Male
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Middle aged
Idioma:
En
Revista:
Dig Dis Sci
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos