Economic evaluation of the introduction of the Prostate Health Index as a rule-out test to avoid unnecessary biopsies in men with prostate specific antigen levels of 4-10 in Hong Kong. Bouttell, J., Teoh, J., Chiu, P. K., Chan, K. S., Ng, C., Heggie, R., & Hawkins, N. PLOS ONE, 14(4):e0215279, April, 2019. ![Economic evaluation of the introduction of the Prostate Health Index as a rule-out test to avoid unnecessary biopsies in men with prostate specific antigen levels of 4-10 in Hong Kong [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex A recent study showed that the Prostate Health Index may avoid unnecessary biopsies in men with prostate specific antigen 4-10ng/ml and normal digital rectal examination in the diagnosis of prostate cancer in Hong Kong. This study aimed to conduct an economic evaluation of the impact of adopting this commercially-available test in the Hong Kong public health service to determine whether further research is justified. A cost-consequence analysis was undertaken comparing the current diagnostic pathway with a proposed diagnostic pathway using the Prostate Health Index. Data for the model was taken from a prospective cohort study recruited at a single-institution and micro-costing studies. Using a cut off PHI score of 35 to avoid biopsy would cost HK$3,000 and save HK$7,988 per patient in biopsy costs and HK$511 from a reduction in biopsy-related adverse events. The net cost impact of the change was estimated to be HK$5,500 under base case assumptions. At the base case sensitivity and specificity for all grades of cancer (61.3% and 77.5% respectively) all grade cancer could be missed in 4.22% of the population and high grade cancer in 0.53%. The introduction of the prostate health index into the diagnostic pathway for prostate cancer in Hong Kong has the potential to reduce biopsies, biopsy costs and biopsy-related adverse events. Policy makers should consider the clinical and economic impact of this proposal.
@article{bouttell_economic_2019-1,
title = {Economic evaluation of the introduction of the {Prostate} {Health} {Index} as a rule-out test to avoid unnecessary biopsies in men with prostate specific antigen levels of 4-10 in {Hong} {Kong}},
volume = {14},
issn = {1932-6203},
url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215279},
doi = {10.1371/journal.pone.0215279},
abstract = {A recent study showed that the Prostate Health Index may avoid unnecessary biopsies in men with prostate specific antigen 4-10ng/ml and normal digital rectal examination in the diagnosis of prostate cancer in Hong Kong. This study aimed to conduct an economic evaluation of the impact of adopting this commercially-available test in the Hong Kong public health service to determine whether further research is justified. A cost-consequence analysis was undertaken comparing the current diagnostic pathway with a proposed diagnostic pathway using the Prostate Health Index. Data for the model was taken from a prospective cohort study recruited at a single-institution and micro-costing studies. Using a cut off PHI score of 35 to avoid biopsy would cost HK\$3,000 and save HK\$7,988 per patient in biopsy costs and HK\$511 from a reduction in biopsy-related adverse events. The net cost impact of the change was estimated to be HK\$5,500 under base case assumptions. At the base case sensitivity and specificity for all grades of cancer (61.3\% and 77.5\% respectively) all grade cancer could be missed in 4.22\% of the population and high grade cancer in 0.53\%. The introduction of the prostate health index into the diagnostic pathway for prostate cancer in Hong Kong has the potential to reduce biopsies, biopsy costs and biopsy-related adverse events. Policy makers should consider the clinical and economic impact of this proposal.},
language = {en},
number = {4},
urldate = {2019-08-06},
journal = {PLOS ONE},
author = {Bouttell, Janet and Teoh, Jeremy and Chiu, Peter K. and Chan, Kevin S. and Ng, Chi-Fai and Heggie, Robert and Hawkins, Neil},
month = apr,
year = {2019},
keywords = {Adverse events, Biopsy, Cancer detection and diagnosis, Critical care and emergency medicine, Hong Kong, Prostate cancer, Prostate gland, Rectum},
pages = {e0215279},
file = {Bouttell et al. - 2019 - Economic evaluation of the introduction of the Pro.pdf:/Users/neil.hawkins/Zotero/storage/D8J6LPH3/Bouttell et al. - 2019 - Economic evaluation of the introduction of the Pro.pdf:application/pdf;Bouttell et al. - 2019 - Economic evaluation of the introduction of the Pro.pdf:/Users/neil.hawkins/Zotero/storage/E6HFBBXY/Bouttell et al. - 2019 - Economic evaluation of the introduction of the Pro.pdf:application/pdf;Bouttell et al. - 2019 - Economic evaluation of the introduction of the Pro.pdf:/Users/neil.hawkins/Zotero/storage/ATDSW4LG/Bouttell et al. - 2019 - Economic evaluation of the introduction of the Pro.pdf:application/pdf;Full Text PDF:/Users/neil.hawkins/Zotero/storage/GDAPTKLP/Bouttell et al. - 2019 - Economic evaluation of the introduction of the Pro.pdf:application/pdf;Snapshot:/Users/neil.hawkins/Zotero/storage/FZGKSVIX/article.html:text/html},
}
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