OP68 Value-Engineered Translation: An Example for Bladder Cancer Diagnosis

2019 ◽  
Vol 35 (S1) ◽  
pp. 17-17
Author(s):  
Andrew Sutton ◽  
John Lamont ◽  
R. Evans ◽  
Kate Williamson ◽  
Declan O'Rourke ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Diagnosis ◽  
Current Practice ◽  
Early Stage ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Test Accuracy ◽  
Regulatory Pathways ◽  
Non Invasive ◽  
Stage Of Development

IntroductionThe Institute of Health Economics offers a suite of analyses that provide developers an understanding of the expected commercial viability of an early stage health technology. In combination, these analyses form the Value-Engineered Translation framework. These methods incorporate innovative methods to manage uncertainty in early economic evaluations, in particular, moving beyond current stochastic assessments of headroom to account for inter-market variability in value hurdles, as well as incorporating social value premia considerations. An illustration of these methods is demonstrated using the example of a non-invasive diagnostic test (called DCRSHP) at an early stage of development, compared to current practice of cystoscopy in the diagnosis of bladder cancer.MethodsCompeting technologies were identified to inform the headroom assessment based on price and effectiveness. Then, a model-based cost-effectiveness analysis was undertaken incorporating headroom analysis, stochastic one-way sensitivity analysis, and value of information analysis using data from secondary sources.ResultsCurrently there are a number of non-invasive tests available, but none have sufficient test accuracy to be suitable for bladder cancer diagnosis alone. From the headroom analysis, DCRSHP can be priced at up to CAD 790 (i.e. USD 588) and still be cost-effective compared to the current practice of cystoscopy. Interestingly this price can be increased for patient groups that have lower levels of bladder cancer prevalence.ConclusionsThe requirements of economic evaluations depend on the stage of technology development, and analysis approaches must reflect this. The results here indicate that DCRSHP clears the value hurdle in terms of being cost-effective, and thus provides the opportunity to make a commercial return on future investment. Future analysis of DCRSHP could consider the cost drivers for development of the technology, including the regulatory pathways, costs associated with the intellectual asset management for the technology, and alternative manufacturing costs. All of which contribute to the research-to-practice continuum.

Review of Various Tasks Performed in the Preprocessing Phase of a Diabetic Retinopathy Diagnosis System

2020 ◽  
Vol 16 (4) ◽  
pp. 397-426
Author(s):  
Muhammad Nadeem Ashraf ◽  
Muhammad Hussain ◽  
Zulfiqar Habib
Keyword(s):  
Diabetic Retinopathy ◽  
Blood Vessels ◽  
Early Stage ◽  
Spherical Shape ◽  
Cost Effective ◽  
Lesion Detection ◽  
Diabetic Patients ◽  
Cad System ◽  
Non Invasive ◽  
Optic Discs

Diabetic Retinopathy (DR) is a major cause of blindness in diabetic patients. The increasing population of diabetic patients and difficulty to diagnose it at an early stage are limiting the screening capabilities of manual diagnosis by ophthalmologists. Color fundus images are widely used to detect DR lesions due to their comfortable, cost-effective and non-invasive acquisition procedure. Computer Aided Diagnosis (CAD) of DR based on these images can assist ophthalmologists and help in saving many sight years of diabetic patients. In a CAD system, preprocessing is a crucial phase, which significantly affects its performance. Commonly used preprocessing operations are the enhancement of poor contrast, balancing the illumination imbalance due to the spherical shape of a retina, noise reduction, image resizing to support multi-resolution, color normalization, extraction of a field of view (FOV), etc. Also, the presence of blood vessels and optic discs makes the lesion detection more challenging because these two artifacts exhibit specific attributes, which are similar to those of DR lesions. Preprocessing operations can be broadly divided into three categories: 1) fixing the native defects, 2) segmentation of blood vessels, and 3) localization and segmentation of optic discs. This paper presents a review of the state-of-the-art preprocessing techniques related to three categories of operations, highlighting their significant aspects and limitations. The survey is concluded with the most effective preprocessing methods, which have been shown to improve the accuracy and efficiency of the CAD systems.

Should we still be testing for asymptomatic non-specific urethritis in departments of genitourinary medicine?

2005 ◽  
Vol 16 (4) ◽  
pp. 273-277 ◽  
Author(s):  
P J Horner
Keyword(s):  
Current Practice ◽  
Cost Effective ◽  
Review Article ◽  
Nucleic Acid Amplification ◽  
Sexually Transmitted ◽  
Non Invasive ◽  
Genitourinary Medicine ◽  
The Cost ◽  
Urine Specimens ◽  
Asymptomatic Men

It has recently been advocated that non-invasive testing with first-catch urine specimens using nucleic acid amplification techniques, to detect Chlamydia trachomatis and Neisseria gonorrhoeae, should replace routine microscopy on asymptomatic men. Although it is assumed that this strategy will be cost effective, the available evidence suggests that this will result in fewer sexually transmitted infections being averted than continuing the current practice of screening for urethritis and testing for both microorganisms in asymptomatic men. This review article summarizes the available evidence and argues that research is urgently needed in order to properly evaluate the cost-effectiveness of detecting urethritis in asymptomatic men.

scholarly journals Biomarkers for Bladder Cancer Diagnosis and Surveillance: A Comprehensive Review

Diagnostics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 39 ◽  
Author(s):  
Rui Batista ◽  
Nuno Vinagre ◽  
Sara Meireles ◽  
João Vinagre ◽  
Hugo Prazeres ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Treatment Response ◽  
Cancer Diagnosis ◽  
Complex Disease ◽  
Molecular Biomarkers ◽  
Clinical Staging ◽  
Response Monitoring ◽  
High Morbidity ◽  
Non Invasive

Bladder cancer (BC) ranks as the sixth most prevalent cancer in the world, with a steady rise in its incidence and prevalence, and is accompanied by a high morbidity and mortality. BC is a complex disease with several molecular and pathological pathways, thus reflecting different behaviors depending on the clinical staging of the tumor and molecular type. Diagnosis and monitoring of BC is mainly performed by invasive tests, namely periodic cystoscopies; this procedure, although a reliable method, is highly uncomfortable for the patient and it is not exempt of comorbidities. Currently, there is no formal indication for the use of molecular biomarkers in clinical practice, even though there are several tests available. There is an imperative need for a clinical non-invasive testing for early detection, disease monitoring, and treatment response in BC. In this review, we aim to assess and compare different tests based on molecular biomarkers and evaluate their potential role as new molecules for bladder cancer diagnosis, follow-up, and treatment response monitoring.

scholarly journals Non-Invasive Biomarkers for Early Detection of Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2767
Author(s):  
Jiawei Li ◽  
Xin Guan ◽  
Zhimin Fan ◽  
Lai-Ming Ching ◽  
Yan Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Early Stage ◽  
False Negative ◽  
Breast Cancer Diagnosis ◽  
Diagnostic Biomarkers ◽  
Circulating Micrornas ◽  
Non Invasive ◽  
Common Cancer ◽  
Volatile Organic

Breast cancer is the most common cancer in women worldwide. Accurate early diagnosis of breast cancer is critical in the management of the disease. Although mammogram screening has been widely used for breast cancer screening, high false-positive and false-negative rates and radiation from mammography have always been a concern. Over the last 20 years, the emergence of “omics” strategies has resulted in significant advances in the search for non-invasive biomarkers for breast cancer diagnosis at an early stage. Circulating carcinoma antigens, circulating tumor cells, circulating cell-free tumor nucleic acids (DNA or RNA), circulating microRNAs, and circulating extracellular vesicles in the peripheral blood, nipple aspirate fluid, sweat, urine, and tears, as well as volatile organic compounds in the breath, have emerged as potential non-invasive diagnostic biomarkers to supplement current clinical approaches to earlier detection of breast cancer. In this review, we summarize the current progress of research in these areas.

scholarly journals Asymptotic modeling of electrochemical signaling: Testing Zn in urine for non-invasive bladder cancer diagnosis

2021 ◽  
Vol 347 ◽  
pp. 130646
Author(s):  
Antonio Doménech-Carbó ◽  
José Luís Pontones ◽  
Clara Doménech-Casasús ◽  
David Ramos
Keyword(s):  
Bladder Cancer ◽  
Cancer Diagnosis ◽  
Invasive Bladder Cancer ◽  
Non Invasive ◽  
Asymptotic Modeling

Prospective validation of a serum miRNA panel for early detection of gastric cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 4065-4065 ◽  
Author(s):  
Lihan Zhou ◽  
Jimmy So ◽  
Ritika Kapoor ◽  
Feng Zhu ◽  
Ruiyang Zou ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prospective Cohort ◽  
Histopathological Examination ◽  
Early Stage ◽  
Cost Effective ◽  
P Value ◽  
Diagnostic Endoscopy ◽  
Non Invasive ◽  
Serum Mirna ◽  
Multi Center Study

4065 Background: High mortality from gastric cancer is related to the late manifestation of its symptoms. A blood-based non-invasive biomarker with the ability to detect all stages of gastric cancer could significantly improve patient outcomes. We aimed to develop a novel serum miRNA assay for diagnosis of gastric cancer. Methods: We conducted a multi-center study involving 892 gastric cancer and control subjects from Singapore and Korea to develop a multi-target miRNA assay. Using RT-qPCR, we quantified the expressions of 578 serum miRNAs and constructed a 12-miR biomarker panel through multi-variant data analysis. The results were generated with the use of a logistic-regression algorithm, with the value of 40 or more considered to be positive. We subsequently validated this multi-miR assay in a large prospective cohort involving 4566 subjects and compared its performance with traditional markers such as H.Pylori and Pepsinogen. All participants underwent gastroscopy independent of the assay results. Results: Of the 4566 subjects that underwent gastroscopy and histopathological examination in the prospective cohort, 125 were diagnosed with gastric cancer. The 12-miR assay achieved an Area-Under-Curve (AUC) of 0.84, significantly outperforming (p-value < 0.01) that of H.Pylori (AUC of 0.64) and Pepsinogen (AUC of 0.62). The sensitivity of the miRNA assay in detecting early (stage 0-2) and late (stage 3-4) stage gastric cancer was 82.6% (95% CI, 68.6% to 92.2%) and 88.4% (95% CI, 78.4% to 94.9%) respectively at a specificity of 70.0% (95% CI, 67.8% to 71.9%). In comparison, H.Pylori showed a sensitivity of 80.4% at a specificity of 44.3% whereas the Pepsinogen showed sensitivity of 9.52% at a specificity of 95.3%. Using the miRNA assay as a pre-screening tool could potentially reduce number of endoscopy needed by 62% in detecting one case of gastric cancer. Conclusions: Our serum miRNA panel is a useful, non-invasive screening test for gastric cancer. It is cost-effective as it can reduce unnecessary diagnostic endoscopy.

scholarly journals Bibliometrics Analysis of Diagnostic Test Accuracy Studies of Bladder Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Yuan Zhang ◽  
Yao Xu ◽  
Shuo Li
Keyword(s):  
Bladder Cancer ◽  
Text Mining ◽  
Cancer Diagnosis ◽  
Test Accuracy ◽  
Research Topics ◽  
Article Type ◽  
Source Journal ◽  
Scopus Database ◽  
Number Of Citations ◽  
Bibliometrics Analysis

Background. Bladder cancer is amongst the top 10 most common neoplasms worldwide. It is responsible for over 150,000 deaths per annum. It is of great importance to study its clinical diagnosis and management. As a literature synthesis technique, bibliometrics analysis helps us to take our knowledge of bladder cancer diagnosis research, topics, and trends a step further. It is critical to elucidate the literature landscape and its pertinent impact on this field, in order to have a better understanding and improved management of bladder cancer. Materials and Methods. Search terms related to bladder cancer diagnosis were used to retrieval publications which met the predefined criteria in the Scopus database developed by Elsevier. Included articles were further evaluated by year of publication, country, language, institution, article type, source journal, coauthorship networks, and text mining of titles. The R software, as well as the tm, ggplot2 packages, and the VOSviewer (version 1.6.15) were used as software tools. Results. A comprehensive literature search in the Scopus database returned a total of 824 publication items. Among them, 601 (72.94%) were published as journal articles, and 117 (14.20%) were published as reviews. The number of annual publications in this field has been increasing in recent years. English represents the language used in the majority of the articles (634, 77.13%). The highest number of citations received for a single article is as high as 628 times. We also clustered and visualized a network of 701 authors with no less than 3 publications. The term cloud and hierarchical clustering dendrogram which revealed with text mining were used to discover the hot research topics in this field. We also statistically analyzed evolution of the major journal impact indices, including Impact Factor, EigenFactor Score, and CiteScore of 11 journals with a period of 9 years. Conclusion. Through bibliometrics analysis, we found hot topics and related research focuses and trends in bladder cancer diagnosis. This bibliometrics analysis has identified influential articles in the field and provides a useful guide to researchers as to what type of article constitutes a highly citable publication in this subject. In addition, a coauthorship network helps researchers find out which team may be a potential partner and where their studies focus on.

scholarly journals Salivary Inflammatory Mediators in Cancer Diagnosis

2021 ◽  
pp. 23-27
Author(s):  
Mohammad F. ◽  
Hala M. Sbaih ◽  
Mohamed J. Saadh
Keyword(s):  
Cause Of Death ◽  
Cancer Diagnosis ◽  
Inflammatory Mediators ◽  
Cost Effective ◽  
Serum Biomarkers ◽  
Non Invasive ◽  
Salivary Biomarkers ◽  
Early Stages ◽  
Invasive Techniques

Cancer is the second leading cause of death worldwide; it can be successfully treated in the early stages. Screening for cancer should be performed in safe, accurate, cost-effective, and non-invasive techniques and therefore achieved the patient convenience. The salivary diagnosis could be a promising era in oncological fields, which have some correlations with serum biomarkers in certain cancers. In this paper, we reviewed some of the salivary biomarkers in detecting different cancers and their origins [genomics, epigenomics, transcriptomics, metabolomics, proteomics, and microbiota].

scholarly journals Improved Non-Invasive Diagnosis of Bladder Cancer with an Electronic Nose: A Large Pilot Study

2021 ◽  
Vol 10 (21) ◽  
pp. 4984
Author(s):  
PierFrancesco Bassi ◽  
Luca Di Gianfrancesco ◽  
Luigi Salmaso ◽  
Mauro Ragonese ◽  
Giuseppe Palermo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Pilot Study ◽  
Sensitivity And Specificity ◽  
Electronic Nose ◽  
False Negative ◽  
Cost Effective ◽  
Combination Method ◽  
Non Invasive ◽  
Phase 2 Study ◽  
Sensitivity Specificity

Background: Bladder cancer (BCa) emits specific volatile organic compounds (VOCs) in the urine headspace that can be detected by an electronic nose. The diagnostic performance of an electronic nose in detecting BCa was investigated in a pilot study. Methods: A prospective, single-center, controlled, non-randomized, phase 2 study was carried out on 198 consecutive subjects (102 with proven BCa, 96 controls). Urine samples were evaluated with an electronic nose provided with 32 volatile gas analyzer sensors. The tests were repeated at least two times per sample. Accuracy, sensitivity, specificity, and variability were evaluated using mainly the non-parametric combination method, permutation tests, and discriminant analysis classification. Results: Statistically significant differences between BCa patients and controls were reported by 28 (87.5%) of the 32 sensors. The overall discriminatory power, sensitivity, and specificity were 78.8%, 74.1%, and 76%, respectively; 13/96 (13.5%) controls and 29/102 (28.4%) BCa patients were misclassified as false positive and false negative, respectively. Where the most efficient sensors were selected, the sensitivity and specificity increased up to 91.1% (72.5–100) and 89.1% (81–95.8), respectively. None of the tumor characteristics represented independent predictors of device responsiveness. Conclusions: The electronic nose might represent a potentially reliable, quick, accurate, and cost-effective tool for non-invasive BCa diagnosis.

scholarly journals A Cost-Effective and Non-Invasive pfeRNA-Based Test Differentiates Benign and Suspicious Pulmonary Nodules from Malignant Ones

2021 ◽  
Vol 7 (4) ◽  
pp. 80
Author(s):  
Wei Liu ◽  
Yuyan Wang ◽  
Hongchan Huang ◽  
Nadege Fackche ◽  
Kristen Rodgers ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Laboratory ◽  
Early Stage ◽  
Pulmonary Nodules ◽  
Cost Effective ◽  
Automatic Testing ◽  
Average Sensitivity ◽  
Prediction Rules ◽  
Lung Cancers ◽  
Non Invasive

The ability to differentiate between benign, suspicious, and malignant pulmonary nodules is imperative for definitive intervention in patients with early stage lung cancers. Here, we report that plasma protein functional effector sncRNAs (pfeRNAs) serve as non-invasive biomarkers for determining both the existence and the nature of pulmonary nodules in a three-stage study that included the healthy group, patients with benign pulmonary nodules, patients with suspicious nodules, and patients with malignant nodules. Following the standards required for a clinical laboratory improvement amendments (CLIA)-compliant laboratory-developed test (LDT), we identified a pfeRNA classifier containing 8 pfeRNAs in 108 biospecimens from 60 patients by sncRNA deep sequencing, deduced prediction rules using a separate training cohort of 198 plasma specimens, and then applied the prediction rules to another 230 plasma specimens in an independent validation cohort. The pfeRNA classifier could (1) differentiate patients with or without pulmonary nodules with an average sensitivity and specificity of 96.2% and 97.35% and (2) differentiate malignant versus benign pulmonary nodules with an average sensitivity and specificity of 77.1% and 74.25%. Our biomarkers are cost-effective, non-invasive, sensitive, and specific, and the qPCR-based method provides the possibility for automatic testing of robotic applications.

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