scholarly journals Cost-effectiveness of patient navigation for lung cancer – a systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 314
Author(s):  
Benjamin Kass ◽  
Christina Dornquast ◽  
Nina Rieckmann ◽  
Ute Goerling ◽  
Christine Holmberg ◽  
...  

Background: Patient navigation (PN) programs have been shown to increase patient satisfaction and quality of life among patients with lung cancer and to decrease time to treatment. However, the general cost-effectiveness of such programs in the context of lung cancer remains unknown. Hence, the aim of the present systematic review was to analyze the scientific literature and quantitatively assess the level of evidence on the cost-effectiveness of PN programs for patients diagnosed with lung cancer.  Methods: A systematic literature search was carried out in PubMed, EMBASE, CENTRAL, CINAHL and PsycINFO databases without time limitations. Randomized controlled trials written in English or German were eligible for inclusion if any results regarding the cost-effectiveness of personally delivered PN programs for patients after lung cancer diagnosis were reported. A manual search was carried out to supplement the systematic search. Additionally, the authors of ongoing or unpublished relevant research were contacted. The titles, abstracts and full texts of relevant citations were screened independently by two reviewers.   Results: The initial search yielded 814 articles, including four papers identified manually. Twenty-one articles were included in the full text screening. However, no study met the inclusion criteria. Contacting the authors of ongoing or unpublished research and cross-cancer studies did not yield any studies that met the inclusion criteria.   Conclusion: Since no study met the inclusion criteria, this study reveals a research gap in this area. Furthermore, no conclusive statement regarding the cost-effectiveness of patient navigation programs for patients diagnosed with lung cancer can be made. Since the implementation of new healthcare models such as PN at least partially depends on their cost-effectiveness, future attempts to evaluate PN programs for lung cancer patients should consider examining outcomes related to cost-effectiveness to overcome the identified research gap.

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 314
Author(s):  
Benjamin Kass ◽  
Christina Dornquast ◽  
Nina Rieckmann ◽  
Ute Goerling ◽  
Christine Holmberg ◽  
...  

Background: Patient navigation (PN) programs have been shown to increase patient satisfaction and quality of life among patients with lung cancer and to decrease time to treatment. However, the general cost-effectiveness of such programs in the context of lung cancer remains unknown. Hence, the aim of the present systematic review was to analyze the scientific literature and quantitatively assess the level of evidence on the cost-effectiveness of PN programs for patients diagnosed with lung cancer.  Methods: A systematic literature search was carried out in PubMed, EMBASE, CENTRAL, CINAHL and PsycINFO databases without time limitations. Randomized controlled trials written in English or German were eligible for inclusion if any results regarding the cost-effectiveness of personally delivered PN programs for patients after lung cancer diagnosis were reported. A manual search was carried out to supplement the systematic search. Additionally, the authors of ongoing or unpublished relevant research were contacted. The titles, abstracts and full texts of relevant citations were screened independently by two reviewers.   Results: The initial search yielded 814 articles, including four papers identified manually. Twenty-one articles were included in the full text screening. However, no study met the inclusion criteria. Contacting the authors of ongoing or unpublished research and cross-cancer studies did not yield any studies that met the inclusion criteria.   Conclusion: Since no study met the inclusion criteria, this study reveals a research gap in this area. Furthermore, no conclusive statement regarding the cost-effectiveness of patient navigation programs for patients diagnosed with lung cancer can be made. Since the implementation of new healthcare models such as PN at least partially depends on their cost-effectiveness, future attempts to evaluate PN programs for lung cancer patients should consider examining outcomes related to cost-effectiveness to overcome the identified research gap.


2019 ◽  
Vol 11 (1) ◽  
pp. e2019036 ◽  
Author(s):  
Jialian Li

Background:Deferoxamine (DFO) or Deferiprone (DFP) or Deferasirox (DFX) monotherapy and DFO and DFP combination therapy were four commonly implemented now chelation regimens for the iron overloaded of β-thalassemia major. This systematic review aims to determine the cost-effectiveness of four chelation regimens and provide evidence for the rational use of chelation regimens for β-thalassemia major therapy in clinic.Methods:A systematic literature search in PubMed, EMBASE (Ovid), CENTRAL (Cochrane library), HTAD (Cochrane library), NHS EED (Cochrane library), CBM, CNKI, VIP, and Wanfang was conducted in April 2018. In addition, a manual search was performed. Two researchers, working independently, selected the papers, extracted the data and assessed the methodological quality of the included papers. Each included paper was evaluated using a checklist developed by Drummond et al. Results:The initial number of records was 968, and eight papers met the final eligibility criteria. All the included eight papers were cost-utility analyses. And the methodological quality of these papers was good. Nineteen studies were included in eight papers. Nine studies of DFX versus DFO had contradictory results. Out of the nineteen studies, three studies of DFX versus DFP established that using DFP was cost-effective. Three studies of DFP versus DFO established that using DFP was cost-effective. One study of DFP and DFO combination therapy versus DFO found that using DFO was cost-effective. One study of DFP and DFO combination therapy versus DFP found that using DFP was cost-effective. And there were two studies of DFP and DFO combination therapy versus DFX, but we cannot be sure which one of two chelation regimens was cost-effective. Conclusion:In brief, DFP is the best choice, followed by DFO or DFX, when an iron chelator is to be used alone for β-thalassemia major therapy. All studies that compared DFO and DFP combination therapy with DFO (or DFP or DFX) monotherapy established that the combination therapy with DFO and DFP was not cost-effective. However, due to the low number of related studies, more extensive, high-quality research is required for further analysis and confirmation of our findings. Moreover, the cost effectiveness is not an absolute issue when in different countries(regions) the results are opposite for other countries(regions). The specific region had a substantial influence on the economy of drugs. Key words: β-thalassemia major, Deferoxamine, Deferiprone, Deferasirox, cost-effectiveness, systematic review


2020 ◽  
Vol 9 (18) ◽  
pp. 1301-1309
Author(s):  
Longfeng Zhang ◽  
Xiaofang Zeng ◽  
Hongfu Cai ◽  
Na Li ◽  
Maobai Liu ◽  
...  

Aim: To analyze the economic impact of nivolumab and chemotherapy in patients with non-small-cell lung cancer (NSCLC) who developed disease progression after platinum-containing dual-drug chemotherapy. Materials & methods: The partitioned survival model was used to analyze the cost-utility of two NSCLC treatments by nivolumab and docetaxel. The clinical data resulted from the Phase III clinical trial. The cost parameters were derived from our previous studies, and the utility parameters were derived from the literature. Results: The quality-adjusted life-years of nivolumab and docetaxel were 0.778 and 0.336. The lifetime direct medical expenses of nivolumab and docetaxel were US$44,707.17 and US$12,826.72. The incremental cost–effectiveness ratio was $72,127.71/quality-adjusted life-year. Conclusion: The combination of chemotherapy, nivolumab is not a cost-effective choice in the second-line treatment of NSCLC.


2021 ◽  
Vol 7 ◽  
pp. 205520762110005
Author(s):  
Cynthia Afedi Hazel ◽  
Sheana Bull ◽  
Elizabeth Greenwell ◽  
Maya Bunik ◽  
Jini Puma ◽  
...  

Objective Evidence backing the effectiveness of mobile health technology is growing, and behavior change communication applications (apps) are fast becoming a useful platform for behavioral health programs. However, data to support the cost-effectiveness of these interventions are limited. Suggestions for overcoming the low output of economic data include addressing the methodological challenges for conducting cost-effectiveness analysis of behavior change app programs. This study is a systematic review of cost-effectiveness analyses of behavior change communication apps and a documentation of the reported challenges for investigating their cost-effectiveness. Materials and methods Four academic databases: Medline (Ovid), CINAHL, EMBASE and Google Scholar, were searched. Eligibility criteria included original articles that use a cost-effectiveness evaluation method, published between 2008 and 2018, and in the English language. Results Out of the 60 potentially eligible studies, 6 used cost-effectiveness analysis method and met the inclusion criteria. Conclusion The evidence to support the cost-effectiveness of behavior change communication apps is insufficient, with all studies reporting significant study challenges for estimating program costs and outcomes. The main challenges included limited or lack of cost data, inappropriate cost measures, difficulty with identifying and quantifying app effectiveness, representing app effects as Quality-adjusted Life Years, and aggregating cost and effects into a single quantitative measure like Incremental Cost Effectiveness Ratio. These challenges highlight the need for comprehensive economic evaluation methods that balance app data quality issues with practical concerns. This would likely improve the usefulness of cost-effectiveness data for decisions on adoption, implementation, scalability, sustainability, and the benefits of broader healthcare investments.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Matteo Buda ◽  
Riccardo D’Ambrosi ◽  
Enrico Bellato ◽  
Davide Blonna ◽  
Alessandro Cappellari ◽  
...  

Abstract Background Revision surgery after the Latarjet procedure is a rare and challenging surgical problem, and various bony or capsular procedures have been proposed. This systematic review examines clinical and radiographic outcomes of different procedures for treating persistent pain or recurrent instability after a Latarjet procedure. Methods A systematic review of the literature was performed using the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases with the combined keywords “failed”, “failure”, “revision”, “Latarjet”, “shoulder stabilization” and “shoulder instability” to identify articles published in English that deal with failed Latarjet procedures. Results A total of 11 studies (five retrospective and six case series investigations), all published between 2008 and 2020, fulfilled our inclusion criteria. For the study, 253 patients (254 shoulders, 79.8% male) with a mean age of 29.6 years (range: 16–54 years) were reviewed at an average follow-up of 51.5 months (range: 24–208 months). Conclusions Eden–Hybinette and arthroscopic capsuloplasty are the most popular and safe procedures to treat recurrent instability after a failed Latarjet procedure, and yield reasonable clinical outcomes. A bone graft procedure and capsuloplasty were proposed but there was no clear consensus on their efficacy and indication. Level of evidence Level IV Trial registration PROSPERO 2020 CRD42020185090—www.crd.york.ac.uk/prospero/


2014 ◽  
Vol 2014 ◽  
pp. 1-28 ◽  
Author(s):  
Faith Donald ◽  
Kelley Kilpatrick ◽  
Kim Reid ◽  
Nancy Carter ◽  
Ruth Martin-Misener ◽  
...  

Background. Improved quality of care and control of healthcare costs are important factors influencing decisions to implement nurse practitioner (NP) and clinical nurse specialist (CNS) roles.Objective. To assess the quality of randomized controlled trials (RCTs) evaluating NP and CNS cost-effectiveness (defined broadly to also include studies measuring health resource utilization).Design. Systematic review of RCTs of NP and CNS cost-effectiveness reported between 1980 and July 2012.Results. 4,397 unique records were reviewed. We included 43 RCTs in six groupings, NP-outpatient (n=11), NP-transition (n=5), NP-inpatient (n=2), CNS-outpatient (n=11), CNS-transition (n=13), and CNS-inpatient (n=1). Internal validity was assessed using the Cochrane risk of bias tool; 18 (42%) studies were at low, 17 (39%) were at moderate, and eight (19%) at high risk of bias. Few studies included detailed descriptions of the education, experience, or role of the NPs or CNSs, affecting external validity.Conclusions. We identified 43 RCTs evaluating the cost-effectiveness of NPs and CNSs using criteria that meet current definitions of the roles. Almost half the RCTs were at low risk of bias. Incomplete reporting of study methods and lack of details about NP or CNS education, experience, and role create challenges in consolidating the evidence of the cost-effectiveness of these roles.


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