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Table 5 Base case analyses of diagnostic strategies

From: Cost-effectiveness of MRI targeted biopsy strategies for diagnosing prostate cancer in Singapore

Diagnostic strategy Comparator 20 years horizon 25 years horizon 35 years horizon
Costs (USD) Incremental costs Effectiveness (QALYs) Incremental effectiveness ICER (cost in USD per QALY gained) ICER (cost in USD per QALY gained)
Strategy 1*: MRI targeted biopsy 9655 10.2236
Strategy 2*: MRI targeted biopsy ➔ Systematic biopsy Strategy 1 10,062 408 10.2451 0.0215 18,975 16,211 14,084
Strategy 3: MRI targeted biopsy ➔ Saturation biopsy Strategy 2 10,333 271 10.2408 −0.0042 Dominated by Strategy 2
Strategy 4*: MRI targeted biopsy ➔ Systematic biopsy ➔ Saturation biopsy Strategy 2 10,357 295 10.2602 0.0152 19,458 15,915 14,106
Strategy 5: Systematic biopsy ➔ MRI targeted biopsy Strategy 4 10,855 498 10.2358 −0.0245 Dominated by Strategy 4
Strategy 6: Systematic biopsy ➔ MRI targeted biopsy ➔ Saturation biopsy Strategy 4 11,086 729 10.2516 −0.0086 Dominated by Strategy 4
  1. Abbreviations: ICER incremental cost-effectiveness ratio, mpMRI multi-parametric magnetic resonance imaging, QALY quality-adjusted life year; USD, US dollar
  2. Note:
  3. 1. MRI targeted biopsy refers to the administration of MRI targeted biopsy combined with systematic biopsy following a positive mpMRI.
  4. 2. Arrow (➔) refers to next sequence of diagnostic test following a negative biopsy result
  5. 3. The diagnostic strategies are organized from the least costly to most mostly strategy based on the analyses for 20-year time horizon. The incremental cost and effectiveness of each strategy is calculated by comparing against the preceding strategy that is not dominated. A dominated strategy is more costly and less effective than the strategy in the immediately preceding row. The strategies with asterisk (*) are not dominated; those without asterisk are dominated.
  6. 4. When Strategy 4 was compared against Strategy 1, the ICER was US$19175.