Evaluating the cost-effectiveness of [18F]FDG-PET/CT for investigation of persistent or recurrent neutropenic fever in high-risk haematology patients

被引：1

作者：

Tew, Michelle ^{[1
]}

Douglas, Abby P. ^{[2
,3
,5
]}

Szer, Jeff ^{[6
,9
,10
]}

Bajel, Ashish ^{[5
,9
,10
]}

Harrison, Simon J. ^{[2
,5
,9
,10
]}

Tio, Shio Yen ^{[2
,3
,5
]}

Worth, Leon J. ^{[2
,3
,5
,7
]}

Hicks, Rodney J. ^{[5
,6
]}

Ritchie, David ^{[6
,9
,10
]}

Slavin, Monica A. ^{[2
,3
,4
,5
,8
]}

Thursky, Karin A. ^{[2
,3
,4
,5
,7
]}

Dalziel, Kim ^{[1
]}

机构：

[1] Univ Melbourne, Ctr Hlth Policy, Melbourne Sch Populat & Global Hlth, Hlth Econ Unit, Melbourne, Australia

[2] Peter MacCallum Canc Ctr, Natl Ctr Infect Canc, Melbourne, Australia

[3] Peter MacCallum Canc Ctr, Dept Infect Dis, Melbourne, Australia

[4] Peter MacCallum Canc Ctr, Dept Hlth Serv Res & Implementat Sci, Melbourne, Australia

[5] Univ Melbourne, Dept Oncol, Melbourne, Australia

[6] Univ Melbourne, Dept Med, Melbourne, Australia

[7] Peter Doherty Inst Infect & Immun, Natl Ctr Antimicrobial Stewardship, Melbourne, Vic, Australia

[8] Royal Melbourne Hosp, Victorian Infect Dis Serv, Melbourne, Vic, Australia

[9] Peter MacCallum Canc Ctr, Dept Clin Haematol, Melbourne, Vic, Australia

[10] Royal Melbourne Hosp, Melbourne, Vic, Australia

来源：

CANCER IMAGING | 2023年 / 23卷 / 01期

基金：

英国医学研究理事会;

关键词：

Cost-effectiveness; Costing; Diagnostic imaging; Febrile neutropenia; Antimicrobial; POSITRON-EMISSION-TOMOGRAPHY; CANCER; INFECTIONS; DIAGNOSIS; ERA;

D O I：

10.1186/s40644-023-00647-7

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background A recent randomised trial demonstrated [F-18]fluorodeoxyglucose positron-emission tomography in combination with low-dose CT (FDG-PET/CT), compared to standard of care computed tomography (CT) imaging, positively impacted antimicrobial management and outcomes of acute leukaemia and haematopoietic stem cell transplant recipients with persistent and recurrent neutropenic fever. We conducted an economic evaluation from a healthcare perspective alongside the clinical trial. Methods Unit costs in Australian dollars were applied to all resources used (antimicrobials, diagnostic tests, ICU and hospital bed days). Effectiveness was measured as number of patients with antimicrobial rationalisation, 6-month mortality and quality-adjusted life years (QALYs) derived from patient-reported trial-based health-related quality-of-life. Generalised linear models were used to analyse costs and outcomes. Incremental cost-effectiveness ratios (ICERs) for all outcomes and net monetary benefit (NMB) for QALYs were calculated. We performed bootstrapping with 1000 replications using the recycled predictions method. Results FDG-PET/CT is cost effective when compared to CT for investigation of persistent/recurrent neutropenic fever in high-risk patients, providing further support for incorporation of FDG-PET/CT into clinical guidelines and funding. Conclusions FDG-PET/CT is cost effective when compared to CT for investigation of persistent/recurrent neutropenic fever in high-risk patients, providing further support for incorporation of FDG-PET/CT into clinical guidelines and funding.

引用

页数：8