Faculty Opinions recommendation of Cost effectiveness and screening interval of lipid screening in Hodgkin's lymphoma survivors.

Purpose Survivors of Hodgkin's lymphoma (HL) who received mediastinal irradiation have an increased risk of coronary heart disease. We evaluated the cost effectiveness of lipid screening in survivors of HL and compared different screening intervals. Methods We developed a decision-analytic model to evaluate lipid screening in a hypothetical cohort of 30-year-old survivors of HL who survived 5 years after mediastinal irradiation. We compared the following strategies: no screening, and screening at 1-, 3-, 5-, or 7-year intervals. Screen-positive patients were treated with statins. Markov models were used to calculate life expectancy, quality-adjusted life expectancy, and lifetime costs. Baseline probabilities, transition probabilities, and utilities were derived from published studies and US population data. Costs were estimated from Medicare fee schedules and the medical literature. Sensitivity analyses were performed. Results Using an incremental cost-effectiveness ratio (ICER) threshold of $100,000 per quality-adjusted life-year (QALY) saved, lipid screening at every interval was cost effective relative to a strategy of no screening. When comparing screening intervals, a 3-year interval was cost effective relative to a 5-year interval, but annual screening, relative to screening every 3 years, had an ICER of more than $100,000/QALY saved. Factors with the most influence on the results included risk of cardiac events/death after HL, efficacy of statins in reducing cardiac events/death, and costs of statins. Conclusion Lipid screening in survivors of HL, with statin therapy for screen-positive patients, improves survival and is cost effective. A screening interval of 3 years seems reasonable in the long-term follow-up of survivors of HL.

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Computed tomography screening for lung cancer in Hodgkin's lymphoma survivors: decision analysis and cost-effectiveness analysis

Annals of Oncology ◽

10.1093/annonc/mdl023 ◽

2006 ◽

Vol 17 (5) ◽

pp. 785-793 ◽

Cited By ~ 23

Author(s):

P. Das ◽

A.K. Ng ◽

C.C. Earle ◽

P.M. Mauch ◽

K.M. Kuntz

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Cost Effectiveness ◽

Decision Analysis ◽

Hodgkin’S Lymphoma ◽

Cost Effectiveness Analysis ◽

Hodgkin's Lymphoma ◽

Effectiveness Analysis ◽

Lymphoma Survivors

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Cancer-Related Fatigue and Muscle Quality in Hodgkin’s Lymphoma Survivors

Integrative Cancer Therapies ◽

10.1177/1534735417712009 ◽

2017 ◽

Vol 17 (2) ◽

pp. 299-305 ◽

Cited By ~ 11

Author(s):

Filipe Dinato de Lima ◽

Martim Bottaro ◽

Ritielli de Oliveira Valeriano ◽

Lorena Cruz ◽

Claudio L. Battaglini ◽

...

Keyword(s):

Physical Activity ◽

Body Composition ◽

Hodgkin’S Lymphoma ◽

Muscle Thickness ◽

Peak Torque ◽

Hodgkin's Lymphoma ◽

Muscle Quality ◽

Activity Levels ◽

Physical Activity Levels ◽

Lymphoma Survivors

The purpose of this study was to compare fatigue, strength, body composition, muscle thickness, and muscle quality between Hodgkin’s lymphoma survivors (HLS) and apparently healthy subjects matched by age, gender, and physical activity levels (CON). Twelve HLS (32.16 ± 8.06) and 36 CON (32.42 ± 7.64) were enrolled in the study. Fatigue was assessed using the 20-item Multidimensional Fatigue Inventory, muscle strength using an isokinetic dynamometer, body composition using dual-energy X-ray absorptiometry, and thickness and muscle quality using B-mode ultrasound. Differences between HLS and CON were analyzed using independent samples t tests. No significant differences were observed between groups for any demographic characteristics: age ( P = .922), weight ( P = .943), height ( P = .511), body mass index ( P = .796), fat mass ( P = .688), fat-free mass ( P = .520), and percent body fat ( P = .446). No significant differences were observed for strength (peak torque; P = .552), relative peak torque ( P = .200), muscle thickness ( P > .05) and muscle quality ( P > .05). However, self-perceived fatigue was significantly higher in HLS than in CON ( P = .009). It appears that when HLS are matched by age and physical activity levels to CON, no significant difference in body composition, muscle thickness, muscle quality, or strength is observed. Self-perceived fatigue, as predicted, is higher in HLS, which may have implications and should be considered when prescribing exercise training to this cancer population.

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