Grant Details
Grant Number: |
1R01CA083960-01A1 Interpret this number |
Primary Investigator: |
Gazelle, G |
Organization: |
Massachusetts General Hospital |
Project Title: |
Cost Effectiveness of Liver Tumor Ablation and Resection |
Fiscal Year: |
2000 |
Abstract
DESCRIPTION (Applicant's abstract): The proposed research seeks to apply
decision analytic techniques in order to evaluate recently developed, minimally
invasive techniques for percutaneous, in-situ tumor ablation in patients with
liver metastases from colorectal carcinoma (CRC). It is now well documented
that long term survival can be improved in patients with limited hepatic
metastases by operative metastasectomy. However, the impact of in-situ ablative
techniques on long-term survival is unknown. In addition, the importance of
diagnostic imaging in selecting candidates for therapy, specifically the impact
of diagnostic accuracy on treatment outcomes, has received relatively little
attention. None of these techniques have been formally evaluated in order to
determine their relative cost effectiveness.
We have recently developed a Markov decision model based on the costs,
performance characteristics, and outcomes of various diagnostic tests and
surgical treatment strategies, in order to evaluate the cost effectiveness of
operative metastasectomy in patients with CRC liver metastases. In the proposed
research, we will further develop, verify, and refine this model in order to
perform cost effectiveness analysis of strategies for diagnostic imaging and
in-situ ablation in patients with CRC liver metastases. We will also explore
the possibility that in-situ ablation, given its generally lower cost,
morbidity, and mortality, could provide relatively cost effective life
extension for patients in whom cure is impossible. Finally, we will investigate
the effect of different analytic perspectives on health outcomes and costs at
the population level. The research is multidisciplinary in nature, and
represents a collaborative effort between researchers in the fields of health
economics, health services research, and clinical cancer care. It will add to
our knowledge base concerning the economic aspects of cancer management, and
will provide guidance in the appropriate use of diagnostic and therapeutic
interventions in patients with hepatic metastases. The research may also
identify areas for potential clinical trials providing direct comparisons of
surgical and percutaneous techniques, and/or evaluations of strategies for
diagnostic liver imaging.
Publications
None