Benjamin A. Herman

Cost-effectiveness of digital mammography breast cancer screening.

BACKGROUND The DMIST (Digital Mammography Imaging Screening Trial) reported improved breast cancer detection with digital mammography compared with film mammography in selected population subgroups, but it did not assess the economic value of digital relative to film mammography screening. OBJECTIVE To evaluate the cost-effectiveness of digital mammography screening for breast cancer. DESIGN Validated, discrete-event simulation model. DATA SOURCES Data from DMIST and publicly available U.S. data. TARGET POPULATION U.S. women age 40 years or older. TIME HORIZON Lifetime. PERSPECTIVE Societal and Medicare. INTERVENTION All-film mammography screening; all-digital mammography screening; and targeted digital mammography screening, which is age-targeted digital mammography (for women <50 years of age) and age- and density-targeted digital mammography (for women <50 years of age or women > or =50 years of age with dense breasts). OUTCOME MEASURES Cost per quality-adjusted life-year (QALY) gained. RESULTS OF BASE-CASE ANALYSIS All-digital mammography screening cost

Comparison of Acquisition Parameters and Breast Dose in Digital Mammography and Screen-Film Mammography in the American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial

331,000 (95% CI,

Computerized tomographic colonography: Performance evaluation in a retrospective multicenter setting

268,000 to

Can radiologist training and testing ensure high performance in CT colonography? Lessons from the national CT colonography trial

403,000) per QALY gained relative to all-film mammography screening but was more costly and less effective than targeted digital mammography screening. Targeted digital mammography screening resulted in more screen-detected cases of cancer and fewer deaths from cancer than either all-film or all-digital mammography screening, with cost-effectiveness estimates ranging from

Comparative Economic Evaluation of Data from the ACRIN National CT Colonography Trial with Three Cancer Intervention and Surveillance Modeling Network Microsimulations

26,500 (CI,

Accuracy and Interpretation Time of Computer-Aided Detection Among Novice and Experienced Breast MRI Readers

21,000 to

Reliability of tumor volume estimation from MR images in patients with malignant glioma. Results from the American College of Radiology Imaging Network (ACRIN) 6662 Trial

33,000) per QALY gained for age-targeted digital mammography to

MR spectroscopy of breast cancer for assessing early treatment response: Results from the ACRIN 6657 MRS trial

84,500 (CI,

CT Colonography for the Detection of Nonpolypoid Adenomas: Sensitivity Assessed With Restricted National CT Colonography Trial Criteria

75,000 to

Patient willingness for repeat screening and preference for CT colonography and optical colonoscopy in ACRIN 6664: the National CT Colonography trial.

93,000) per QALY gained for age- and density-targeted digital mammography. In the Medicare population, the cost-effectiveness of density-targeted digital mammography screening varied from a base-case estimate of