Effectiveness and cost effectiveness of OralCDx brush biospy compared to conventional oral examination [sic]
MetadataShow full item record
OralCDx brush biopsy was developed to improve clinicians' diagnosis during oral cancer screening. However it is unclear if truly improves clinicians' diagnosis, and provides value for the money spent. OBJECTIVES l) To determine the effectiveness of OralCDx brush biopsy in a population with low oral and pharyngeal cancer (OPC) prevalence compared to conventional oral examination (COE). 2) To determine the economic consequences of OralCDx brush biopsy in a target population appropriate for brush biopsy, compared to oral surgeons' (OS) COE. METHODOLOGY In this hypothetical study a best-case scenario for brush biopsy (99% sensitivity and 99% specificity), and a worst-case scenario for COE (79.6% sensitivity and 97.7% specificity) was set. To achieve the first objective, we estimated and compared the positive predictive values (PPV) for brush biopsy and COE in high-risk (HR), low-risk (LR), and the general US population (GP) groups. To assess the extent to which the PPV changes, we performed a sensitivity analysis by adjusting the sensitivity and specificity of brush biopsy in HR, LR, and GP groups. To achieve the second objective, we compared two decision analysis arms: brush biopsy, and COE by OS. A non-reference case cost effectiveness analysis from an insurance company perspective, including only the direct medical costs was conducted. Costs and healthy days gained over a period of 5-years were discounted at rate of 3% per year. No willingness to pay threshold (WTP) was set. AnaIysis of influence, two way, and probabilistic sensitivity analyses were performed. [TRUNCATED]
PLEASE NOTE: This work is protected by copyright. Downloading is restricted to the BU community: please click Download and log in with a valid BU account to access. If you are the author of this work and would like to make it publicly available, please contact firstname.lastname@example.org.Dissertation (DScD) --Boston University, Henry M. Goldman School of Dental Medicine, 2010 (Department of Health Policy and Health Services Research)Includes bibliographic references: leaves 161-175.
RightsThis work is protected by copyright. Downloading is restricted to the BU community. If you are the author of this work and would like to make it publicly available, please contact email@example.com.