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

Eleuteri, A ORCID: 0000-0003-0718-6672, Rola, AC, Kalirai, H ORCID: 0000-0002-4440-2576, Hussain, R ORCID: 0000-0001-8208-5009, Sacco, J, Damato, BE, Heimann, H, Coupland, SE ORCID: 0000-0002-1464-2069 and Taktak, AFG (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-. ISSN 0010-4825, 1879-0534

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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 χ²(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 & Life Sciences Faculty of Health & Life Sciences > Clinical Directorate Faculty of Health & Life Sciences > Inst. Systems, Molec & Integrative Biology > Inst. Systems, Molec & Integrative Biology Faculty of Science & Engineering > School of Physical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	07 Jul 2021 10:33
Last Modified:	23 Jan 2026 13:10
DOI:	10.1016/j.compbiomed.2021.104221
Open Access URL:	https://doi.org/10.1016/j.compbiomed.2021.104221
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3129139
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