| Japanese |
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| Title | 肺腫瘍 (非小細胞癌) における胸部FDG-PETの医療経済効果に関する判断分析 (第I報) |
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| Subtitle | 原著 |
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| Authors | 小須田茂*, 市原清志**, 渡辺真純***, 小林英夫****, 草野正一* |
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| Authors(kana) | |
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| Organization | *防衛医科大学校放射線医学講座, **川崎医科大学検査診断学科, ***防衛医科大学校第二外科学講座, ****防衛医科大学校第三内科学講座 |
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| Journal | 核医学 |
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| Volume | 35 |
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| Number | 6 |
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| Page | 395-404 |
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| Year/Month | 1998/7 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」現行の判断樹および検査の診断データに基づき, 非小細胞癌(病期IIIB以下)における胸部FDG-PETの, 諸検査料, 入院手術費, 余命を含めた医療経済効果に関して, 判断分析を行った. 効果分析の対象(有病率71.4%)を1,000例とし, 全例胸部CT後に胸部FDG-PETを得るものとした. その結果, 気管支鏡生検を約半数に減じ, 縦隔鏡生検と治癒手術例を増加(115例)させ, 非治癒手術を減少させる(51例). このため, 軽度ながら医療費の高騰(胸部FDG-PETの1検査コストを10万円とした場合: 10.5%の割高)をもたらすが, 平均余命を軽度延長させる(0.607年/患者). 胸部FDG-PETの1検査コストを10万円とすると, その医療費増額分は21.8万円/年/患者となる. 非小細胞癌における胸部CT + 胸部FDG-PETプログラムは cost-effective ではないにしても, 費用便益分析上, 有用であると思われる. |
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| Practice | 臨床医学：一般 |
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| Keywords | Decision tree analysis, Sensitivity analysis, Cost-effectiveness, FDG-PET, Lung cancer |
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| English |
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| Title | Decision Tree Sensitivity Analysis for Cost-Effectiveness of Chest FDG-PET in Patients with a Pulmonary Tumor (Non-small Cell Carcinoma) |
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| Subtitle | Original Articles |
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| Authors | Shigeru KOSUDA*, Kiyoshi ICHIHARA**, Masumi WATANABE***, Hideo KOBAYASHI****, Shoichi KUSANO* |
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| Authors(kana) | |
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| Organization | *Department of Radiology, National Defense Medical College, **Department of Diagnosis, Kawasaki Medical College, ***Second Department of Surgery, National Defense Medical College, ****Third Department of Internal Medicine, National Defense Medical College |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 35 |
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| Number | 6 |
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| Page | 395-404 |
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| Year/Month | 1998/7 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, <= Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis. |
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| Practice | Clinical medicine |
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| Keywords | Decision tree analysis, Sensitivity analysis, Cost-effectiveness, FDG-PET, Lung cancer |
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