dc.contributor.author | Yu, G | |
dc.contributor.author | Rice, S | |
dc.contributor.author | Heer, R | |
dc.contributor.author | Lewis, R | |
dc.contributor.author | Vadiveloo, T | |
dc.contributor.author | Mariappan, P | |
dc.contributor.author | Penegar, S | |
dc.contributor.author | Clark, E | |
dc.contributor.author | Tandogdu, Z | |
dc.contributor.author | Hall, E | |
dc.contributor.author | Vale, L | |
dc.coverage.spatial | Netherlands | |
dc.date.accessioned | 2024-08-09T11:17:03Z | |
dc.date.available | 2024-08-09T11:17:03Z | |
dc.date.issued | 2023-07-01 | |
dc.identifier | S2666-1683(23)00243-4 | |
dc.identifier.citation | European Urology Open Science, 2023, 53 pp. 67 - 77 | en_US |
dc.identifier.issn | 2666-1691 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/6349 | |
dc.identifier.eissn | 2666-1683 | |
dc.identifier.eissn | 2666-1683 | |
dc.identifier.doi | 10.1016/j.euros.2023.05.003 | |
dc.identifier.doi | 10.1016/j.euros.2023.05.003 | |
dc.description.abstract | BACKGROUND: Recurrence of non-muscle-invasive bladder cancer (NMIBC) is common after transurethral resection of bladder tumour (TURBT). Photodynamic diagnosis (PDD) may reduce recurrence. PDD uses a photosensitiser in the bladder that causes the tumour to fluoresce to guide resection. PDD provides better diagnostic accuracy and allows more complete tumour resection. OBJECTIVE: To estimate the economic efficiency of PDD-guided TURBT (PDD-TURBT) in comparison to white light-guided TURNT (WL-TURBT) in individuals with a suspected first diagnosis of NMIBC at intermediate or high risk of recurrence on the basis of routine visual assessment before being scheduled for TURBT. DESIGN SETTING AND PARTICIPANTS: This is a health economic evaluation alongside a pragmatic, open-label, parallel-group randomised trial from a societal perspective. A total of 493 participants (aged ≥16 yr) were randomly allocated to PDD-TURBT (n = 244) or WL-TURBT (n = 249) in 22 UK National Health Service hospitals. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Cost effectiveness ratios were based on the use of health care resources associated with PDD-TURBT and WL-TURBT and quality-adjusted life years (QALYs) gained within the trial. Uncertainties in key parameters were assessed using sensitivity analyses. RESULTS AND LIMITATIONS: On the basis of the use of resources driven by the trial protocol, the incremental cost effectiveness of PDD-TURBT in comparison to WL-TURBT was not cost saving. At 3 yr, the total cost was £12 881 for PDD-TURBT and £12 005 for WL-TURBT. QALYs at three years were 2.087 for PDD-TURBT and 2.094 for WL-TURBT. The probability that PDD-TURBT is cost effective was never >30% above the range of societal cost-effectiveness thresholds. CONCLUSIONS: There was no evidence of a difference in either costs or QALYs over 3-yr follow-up between PDD-TURBT and WL-TURBT in individuals with suspected intermediate- or high-risk NMIBC. PDD-TURBT is not supported for the management of primary intermediate- or high-risk NMIBC. PATIENT SUMMARY: We assessed overall costs for two approaches for removal of bladder tumours in noninvasive cancer and measured quality-adjusted life years gained for each. We found that use of a photosensitiser in the bladder was not more cost effective than use of white light only during tumour removal. | |
dc.format | Electronic-eCollection | |
dc.format.extent | 67 - 77 | |
dc.language | eng | |
dc.language.iso | eng | en_US |
dc.publisher | ELSEVIER | en_US |
dc.relation.ispartof | European Urology Open Science | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | en_US |
dc.subject | Cost effectiveness | |
dc.subject | Hexvix | |
dc.subject | Non–muscle-invasive bladder cancer | |
dc.subject | Photodynamic diagnosis | |
dc.subject | Randomised trial | |
dc.subject | Surgery | |
dc.subject | Transurethral resection of bladder tumour | |
dc.subject | Urinary bladder neoplasms | |
dc.title | Photodynamic Diagnosis-guided Transurethral Resection of Bladder Tumour in Participants with a First Suspected Diagnosis of Intermediate- or High-risk Non-muscle-invasive Bladder Cancer: Cost-effectiveness Analysis Alongside a Randomised Controlled Trial. | en_US |
dc.type | Journal Article | |
dcterms.dateAccepted | 2023-05-12 | |
dc.date.updated | 2024-08-08T09:38:51Z | |
rioxxterms.version | VoR | en_US |
rioxxterms.versionofrecord | 10.1016/j.euros.2023.05.003 | en_US |
rioxxterms.licenseref.startdate | 2023-07-01 | |
rioxxterms.type | Journal Article/Review | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/37441343 | |
pubs.organisational-group | ICR | |
pubs.organisational-group | ICR/Primary Group | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit | |
pubs.publication-status | Published online | |
pubs.publisher-url | http://dx.doi.org/10.1016/j.euros.2023.05.003 | |
pubs.volume | 53 | |
icr.researchteam | Clin Trials & Stats Unit | en_US |
dc.contributor.icrauthor | Lewis, Rebecca | |
dc.contributor.icrauthor | Penegar, Steven | |
dc.contributor.icrauthor | Hall, Emma | |
icr.provenance | Deposited by Ms Jessica Phelps (impersonating Prof Emma Hall) on 2024-08-08. Deposit type is initial. No. of files: 1. Files: Photodynamic Diagnosis-guided Transurethral Resection of Bladder Tumour in Participants with a First Suspected Diagnosis of .pdf | |