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To evaluate the health economy of the whole-process management strategy of personalized lung cancer screening according to the size of lung nodules compared with the annual screening strategy and the natural development strategy.
Based on the publicly available dataset from the US NLST, a decision tree-Markov model was constructed. Incremental cost-utility analysis was used to evaluate the economic efficiency of the three strategies, and one-way sensitivity analysis and probabilistic sensitivity analysis were conducted to test the stability of the model results.
Compared with the natural development strategy, the incremental cost-utility ratios (ICER) of the whole-process management strategy and the annual screening strategy were 82 798.96 yuan/quality-adjusted life year (QALY) and 71 168.05 yuan/QALY, respectively.Compared with the annual screening strategy, the ICER of the whole management strategy was 129 227.28 yuan/QALY. Univariate sensitivity analysis showed that the proportion of lung cancer patients with stage III and IV lung cancer had a significant impact on ICER. Probability sensitivity analysis showed that when the Willingness to pay (WTP) was 89 358 yuan/QALY, the economic probability of the whole management strategy was 0.279. When WTP was 268 074 yuan/QALY, the economic probability of the whole process management strategy was 0.826.
When WTP is 1 time the Gross Domestic Product (GDP), the annual screening strategy is the best choice. When WTP is 3 times the GDP per capita, the whole-process management strategy is the best choice.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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