Cost-utility analysis of a decade of liver screening for metastases using the Liverpool Uveal Melanoma Prognosticator Online (LUMPO)



Eleuteri, Antonio ORCID: 0000-0003-0718-6672, Rola, Alda Cunha, Kalirai, Helen ORCID: 0000-0002-4440-2576, Hussain, Rumana ORCID: 0000-0001-8208-5009, Sacco, Joseph, Damato, Bertil E, Heimann, Heinrich, Coupland, Sarah E ORCID: 0000-0002-1464-2069 and Taktak, Azzam FG
(2021) Cost-utility analysis of a decade of liver screening for metastases using the Liverpool Uveal Melanoma Prognosticator Online (LUMPO). COMPUTERS IN BIOLOGY AND MEDICINE, 130. 104221-.

Access the full-text of this item by clicking on the Open Access link.

Abstract

This paper outlines a method for cost-utility analysis of liver screening for metastases in patients with posterior uveal melanoma (UM). A semiparametric model of the cumulative incidence of onset of liver metastases was fitted to a retrospective data set of 615 subjects with clinical follow-up with respect to liver surveillance imaging and outcome. The model was internally validated via bootstrap resampling in terms of its discrimination and calibration performance. Receiver operating characteristics (ROC) were derived at different time points. The discrimination performances are consistent across time. The area under the ROC curve at 5 years post treatment was 0.85 [95% CI: 0.81-0.88]. A goodness-of-fit test gives χ<sup>2</sup>(10)=5.3,p=0.9 demonstrating no evidence against the null hypothesis of zero difference between observed and expected onset of metastatic events. Results showed that at 80% sensitivity, 87% of UM patients will avoid unnecessary radiological scans. This provides potential cost savings of between £46,000 and £97,000 per year to the National Health Service assuming 600 new cases per year.

Item Type: Article
Uncontrolled Keywords: Cost-utility, Prognostication, Uveal melanoma, Screening, Liver metastases
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Clinical Directorate
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Faculty of Science and Engineering > School of Physical Sciences
Depositing User: Symplectic Admin
Date Deposited: 07 Jul 2021 10:33
Last Modified: 18 Jan 2023 21:36
DOI: 10.1016/j.compbiomed.2021.104221
Open Access URL: https://doi.org/10.1016/j.compbiomed.2021.104221
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3129139