Background
Materials and methods
Eligibility criteria
Search strategy
Study selection
Data extraction
Results
Study | Country | Population | Type of test |
---|---|---|---|
Alberts et al. [36] | USA | CRC patients with stage II, T3, MMR-P | Oncotype DX (12-gene assay) |
Barone et al. [34] | IT | High-risk non-mCRC patients | KRAS mutation testing |
Barzi et al. [17] | USA | Healthy individuals | IHC, Amsterdam criteria, MMR, PREMM, germline, BRAF, MSI, RBG |
Behl et al. [33] | USA | Patients with mCRC | KRAS and BRAF mutation testing |
Blank et al. [31] | CH | Patients with mCRC who are chemorefractory | KRAS and BRAF mutation testing |
Dinh et al. [27] | USA | Population aged 20 years or over | Genetic sequencing and rearrangement; single-site testing; IHC; MSI |
Gallego et al. [18] | USA | CRC patients with genetic mutations | NGS; IHC; BRAF V600E |
Gausachs et al. [19] | NR (Probably ES) | CRC patients with genetic mutations | BRAF V600E, MLH1 promoter hypermethylation |
Gould-Suarez et al. [20] | USA | CRC patients | RBG, BRAF targeted mutation analysis, IHC; MSI, MMR gene sequencing |
Gudgeon et al. [21] | USA | CRC patients | IHC staining for the 4 MMR proteins, MSI, BRAF mutation, MMR gene sequencing/rearrangement analyses (Seq-Rearr), and methylation of the MLH1 promoter. (tumor testing and genetic testing) |
Ladabaum et al. [28] | USA | CRC patients and their relatives | Amsterdam, IHC, BRAF, MSI, MMR, PREMM, RBG |
Leenen et al. [22] | DE | CRC patients | MSI, IHC, MMR gene sequencing, RBG |
Severin et al. [23] | DE | CRC patients and their relatives | IHC, MSI, BRAF V600 mutation, genetic sequencing, MMR, Amsterdam criteria, RBG |
Sie et al. [24] | DE | CRC patients and their relatives | IHC, MSI, MLH1, germline |
Snowsill et al. [26] | UK, Wal | CRC patients aged under 50 years and their FDRs | MSI, IHC, BRAF V600E, Amsterdam criteria |
Snowsill et al. [25] | UK | CRC patients aged under 50 years | IHC, MSI, BRAF |
Vijayaraghavan et al. [32] | USA, DE | Patients with mCRC in 2nd-line treatment | KRAS mutation testing |
Wang et al. [29] | USA | CRC patients (at a mean age of 48 years in the base case) and their relatives (at a mean age of 25 years) | IHC, BRAF, MSI, RBG, Amsterdam criteria, MMRpredict, MMRpro, PREMM, germline |
Wang et al. [30] | SG | 21-year-old FDRs of mutation-confirmed LS cases | NR |
Westwood et al. [35] | UK, Wal | Adult mCRC whose metastases are confined to liver and are unresectable | KRAS mutation testing |
Hereditary
Study | Health outcomes | Measurement of effectiveness | WTPa |
---|---|---|---|
Alberts et al. [36] | QALY | Cost saving | 47,438 €/QALY |
Barone et al. [34] | QALY | ICER | 60,000 €/QALY |
Barzi et al. [17] | LYG | ICER | 47,438 €/LYG |
Behl et al. [33] | LYG | ICER | 98,876 €/QALY |
Blank et al. [31] | QALY | ICER | 47,438–98,876 €/QALY (USA); 23,342–35,014 €/QALY (UK) |
Dinh et al. [27] | QALY/LYG | ICER | 47,438 €/QALY |
Gallego et al. [18] | QALY | ICER | 98,876 €/QALY |
Gausachs et al. [19] | Incremental increase in N. of cases detected | ICER | NR |
Gould-Suarez et al. [20] | Incremental increase in N. of cases detected | ICER | NR |
Gudgeon et al. [21] | Incremental increase in N. of cases detected | ICER | NR |
Ladabaum et al. [28] | LYG | ICER | 47,438 €/LYG |
Leenen et al. [22] | LYG | ICER | 40,000 €/LYG |
Severin et al. [23] | LYG | ICER | 50,000 €/LYG |
Sie et al. [24] | LYG | ICER | 80,000 €/LYG |
Snowsill et al. [27] | QALY | ICER | 23,342 €/QALY |
Snowsill et al. [25] | QALY | ICER | NR |
Vijayaraghavan et al. [32] | LYG | ICER | NR |
Wang et al. [29] | QALY | ICER | NR |
Wang et al. [30] | LYG | ICER | NR |
Westwood et al. [35] | QALY | ICER | 19,841 €/QALY |
LS diagnosis
Diagnosis and management of LS
KRAS
Prognosis
Summary of general characteristics of models and their adherence to CHEERS
Authors | Unit costs | Type of economic evaluation | Model | Model assumptions | Perspective | Time horizon | Discount rate (%) |
---|---|---|---|---|---|---|---|
Alberts et al. [36] | $, 2014 | CUA | DAM, decision tree, Markov model | (a) In the absence of RCTs data, relative risk reduction was set according to the NCCN guidelines | Healthcare system perspective | Lifetime | 3 |
Barone et al. [34] | €, 2012 | CUA | DAM | (a) The level of risk of developing metastatic disease was set at the level of 1 patients out of 2, 1/3, 1/4, 1/5 and 1/10 | Healthcare system perspective | NR | NR |
Barzi et al. [17] | $, NR | CEA | Decision tree, Markov model | (a) The first-degree relatives of probands were considered as the healty individuals affected with LS who would be offered preventive measures | Societal perspective | Lifetime | NR |
Behl et al. [33] | $, 2010 | CEA | Markov model | (a) The difference in survivals among alternatives and the referent strategy (1) depends exclusively on a lack of response to (1) | Healthcare system perspective | 10 years | 3 |
Blank et al. [31] | €, 2010 | CUA | Markov model | (a) A high number of assumptions related to the composition of the patient population | Healthcare system perspective | Lifetime | 3 |
Dinh et al. [27] | $, 2009 | CUA | Cohort simulation model | (a) Single-site testing only offered to FDRs of probands | Societal perspective | NR | 3 |
Gallego et al. [18] | $, 2014 | CUA | Decision tree | (a) Assumptions relying on the population involved in the model. Firstly, only FDRs have been considered, then universal screening has been evaluated | Healthcare system perspective | Lifetime | 3 |
Gausachs et al. [19] | €, NR | CEA | Decision tree | (a) Assumptions related to the prevalence of germline mutation | Healthcare system perspective | NR | NR |
Gould-Suarez et al. [20] | $, NR | CEA | Decision tree | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | NR | NR |
Gudgeon et al. [21] | $, 2010 | CEA | DAM | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | NR | NR |
Ladabaum et al. [28] | $, 2010 | CEA | Decision tree with Markov subtrees | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | Lifetime (or 100 years) | 3 |
Leenen et al. [22] | €, 2013 | CEA | DAM | (a) Assumptions made on uncertain parameters such as CRC risk for LS carriers, the method and risk reduction of LS surveillance and assumed adherence to LS surveillance programs | Healthcare system perspective | NR | 3 |
Severin et al. [23] | €, 2012 | CEA | DAM, decision tree, Markov model | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | Lifetime (or 120 years) | 3 |
Sie et al. [24] | €, 2013 | CEA | DAM, decision tree, Markov chain analysis | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | 30 years | 4 |
Snowsill et al. [26] | £, 2013/14 | CUA | DAM, decision tree | (a) In the absence of RCTs data, estimates were sought from clinical experts | Healthcare system perspective | Lifetime (or 100 years) | 3.5 |
Snowsill et al. [25] | £, 2013–14 | CUA | Decision tree, individual patient simulation model | The rate of acceptance of a test was independent of any previous tests, and acceptance of one genetic test implied acceptance of all genetic testing | Healthcare system perspective | Lifetime | 3.5 |
Vijayaraghavan et al. [32] | $ and €, 2009 | CEA | Markov model | (a) Patients with KRAS mutant tumors received no benefit from EGFR inhibitors; (b) patients with KRAS mutant tumors received some benefit from combination therapy containing FOLFIRI or irinotecan; (c) KRAS mutation testing has a sentitivity of 95% and a specifity of 100%; (d) effectivess of cetuximab + FOLFIRI was equivalent to the effectiveness of cetuximab + Irinotecan | Healthcare system perspective | Lifetime | NR |
Wang et al. [29] | $, 2010 | CUA | DAM, Decision tree, Markov subtrees | Different clinical management programs and acceptance rates among probands and relatives until age 75 years based on their germline testing results and cancer risk were modeled | Healthcare system perspective | Lifetime | 3 |
Wang et al. [30] | SGD, 2010 | CEA | DAM, Decision tree, Markov subtrees | Related to compliance rates | Healthcare system perspective | Lifetime | 3 |
Westwood et al. [35] | £, 2011 | CUA | Decision tree, Markov model | (a) Assumption of equal prognostic value analysis for all tests for which information on technical performance was available from the online survey; (b) the differences between the outcomes of evaluated trials are exclusively caused by the different tests used; (c) test accuracy based on objective response can be compared with accuracy based on resection rates | Healthcare system perspective | Lifetime | 3.5 |