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A Journal on Nuclear Medicine and Molecular Imaging
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Guest Editor: Gambhir S. S.


The Quarterly Journal of Nuclear Medicine 2000 June;44(2):186-90

language: English

Utility evaluations for Markov states of lung cancer for PET-based disease management

Papatheofanis F. J.

From the Department of Radiology The Advanced Medical Technology Assessment and Policy Program UCSD School of Medicine, San Diego, CA, USA


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Background. Utilities for the ­health out­comes ­states (Markov ­states) of non-­small ­cell ­lung car­ci­no­ma (NSCLC) ­should be meas­ured to eval­u­ate man­age­ment ­options for ­patients ­because ­patients are key par­tic­i­pants in the pro­cess of ­care, and ­their assess­ment of diag­nos­tic and ther­a­peu­tic val­ue in the ­options pre­sent­ed to ­them ulti­mate­ly ­impacts ­their net ­health out­comes. This inves­ti­ga­tion ­sought to meas­ure util­ities for ­stage-depen­dent out­comes ­states of ­NSCLC.
Methods. Persons (n=23) ­with sus­pect­ed ­NSCLC ­based on phys­i­cal find­ings and com­put­ed tomog­ra­phy com­plet­ed a ­short util­ities sur­vey. Utility val­u­a­tions ­were ­obtained accord­ing to sever­ity of mor­bid­ity and var­ied con­sid­er­ably. Respondents rat­ed ­these ­health ­states accord­ing to accu­ra­cy meas­ures for 18flu­rod­e­ox­y­glu­cose (18FDG) posi­tron emis­sion tomog­ra­phy (PET) imag­ing and med­i­as­ti­nos­co­py.
Results. The ­results dem­on­strate ­that ­stage-depen­dent mor­bid­ity is an impor­tant con­sid­er­a­tion for ­patients ­with ­NSCLC and ­should be includ­ed in any deci­sion anal­y­sis regard­ing the eval­u­a­tion or treat­ment of ­NSCLC. Respondents val­ued the qual­ity of infor­ma­tion ­obtained ­from non-inva­sive PET and inva­sive med­i­as­ti­nos­co­py com­par­ably. The util­ities ­obtained ­from ­this inves­ti­ga­tion are use­ful in clin­i­cal deci­sion-mak­ing ­based on Markov pro­cess­es ­because ­they pro­vide an ­initial esti­ma­tion of util­ity assess­ment for 18FDG-­based diag­nos­tic eval­u­a­tion of ­lung can­cer.
Conclusions. Consequently, ­these util­ities ­will be use­ful in ­future deci­sion anal­y­ses ­that ­require ­patient pref­er­ence in the assign­ment of the val­u­a­tion of deci­sion ­options (branch­es).

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