Cost-Effectiveness of Radiofrequency Ablation for Small, Incidental Renal Tumors

射频消融治疗小型偶发肾肿瘤的成本效益

基本信息

批准号：
8077882
负责人：
Pari Vijay Pandharipande
金额：
$ 17.88万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-03 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8077882
关键词：
Ablation Accounting Advocate Award Behavior Benefits and Risks Benign Biopsy Cancer Patient Caring Cessation of life Clinical Clinical Trials Design Comorbidity Computer Simulation Cost Analysis Cost Effectiveness Analysis Data Data Collection Decision Analysis Detection Development Plans Diagnosis Diagnostic Disease model Effectiveness Epidemiology Evaluation Feasibility Studies Foundations Future General Population Goals Growth Histologic Histology Image Incidence Indolent Intervention Kidney Neoplasms Literature Living Costs Malignant - descriptor Malignant Neoplasms Modeling Natural History Nephrectomy Nephrons Operative Surgical Procedures Outcome Outcomes Research Pathology Patients Policies Practice Guidelines Process Quality of life Radiofrequency Interstitial Ablation Radiology Specialty Recurrence Relative (related person)Renal Cell Carcinoma Renal carcinoma Reporting Research Research Institute Research Personnel Resources Risk Role Science Simulate Solid Specimen Surveys Survival Rate Techniques Technology Testing Therapy Evaluation Treatment Cost Uncertainty United States Urology Use Effectiveness base career career development cost cost effective cost effectiveness economic outcome health economics improved insight interest markov model minimally invasive multidisciplinary neoplasm registry oncology research and development routine therapy simulation standard of care treatment strategy trend tumor

项目摘要

DESCRIPTION (provided by applicant): My goal is to determine the clinical role of a minimally invasive therapy - percutaneous radiofrequency ablation (RFA) - for patients with small, incidentally detected renal tumors, by comparing RFA to surgery, the current standard of care. 1 will accomplish this goal using a decision-analytic approach. First, I will estimate the long-term effectiveness of RFA and surgery by developing a computer model that simulates the natural history of incidentally detected renal tumors, based on data from the literature and the SEER cancer registry. Second, I will collect patient data to improve quality-of-life and cost estimates associated with RFA and surgery, respectively - these estimates are either unavailable or insufficiently reported in the literature to, date. Third, I will perform a cost-effectiveness analysis in which I will compare RFA to surgery, using the effectiveness, quality-of-life, and cost data obtained. Finally, I will perform an extensive, probabilistic sensitivity analysis to estimate the uncertainty associated with analysis results. My career objective is to improve cancer outcomes by defining the best roles for imaging-based technologies in the care of cancer patients. I have pursued a unique career path that integrates cancer outcomes research, decision analysis, and radiology. I am part of a clinical division that serves as a large referral center for renal tumor RFA, and an outcomes research institute that has a wealth of resources to support decision analysis research. I have formulated a multidisciplinary team in decision science, epidemiology, radiology, urology, oncology, and pathology who currently advise in my research and career development, and will continue to do so during the award period. The research and career development plan that I outline in this proposal will provide me with a solid foundation for ongoing renal tumor therapy evaluation, from which I will transition to an independent investigator and leader in cancer outcomes research. RELEVANCE: My research will establish the role of percutaneous radiofrequency ablation - a minimally invasive tumor therapy - in the treatment of small, incidentally detected renal tumors. Insights from my research will improve practice guidelines for the use of radiofrequency ablation, and may ultimately preclude the need for surgery in patients with small, incidentally detected renal tumors.

描述（由申请人提供）：我的目标是通过将 RFA 与手术（当前的护理标准）进行比较，确定微创治疗 - 经皮射频消融 (RFA) - 对于偶然发现的小型肾肿瘤患者的临床作用。 1 将使用决策分析方法来实现这一目标。首先，我将根据文献和 SEER 癌症登记处的数据，开发一个计算机模型来模拟偶然发现的肾肿瘤的自然史，从而估计 RFA 和手术的长期有效性。其次，我将收集患者数据，以分别改善与 RFA 和手术相关的生活质量和成本估算 - 这些估算要么不可用，要么在迄今为止的文献中报道不充分。第三，我将使用获得的有效性、生活质量和成本数据进行成本效益分析，将 RFA 与手术进行比较。最后，我将进行广泛的概率敏感性分析，以估计与分析结果相关的不确定性。我的职业目标是通过定义基于成像的技术在癌症患者护理中的最佳作用来改善癌症结果。我追求一条独特的职业道路，将癌症结果研究、决策分析和放射学融为一体。我所在的临床部门是肾肿瘤 RFA 的大型转诊中心，也是结果研究机构，拥有丰富的资源来支持决策分析研究。我组建了一个决策科学、流行病学、放射学、泌尿学、肿瘤学和病理学领域的多学科团队，他们目前为我的研究和职业发展提供建议，并将在获奖期间继续这样做。我在本提案中概述的研究和职业发展计划将为我正在进行的肾肿瘤治疗评估提供坚实的基础，我将从中过渡到癌症结果研究的独立研究者和领导者。相关性：我的研究将确定经皮射频消融（一种微创肿瘤疗法）在治疗偶然发现的小型肾肿瘤中的作用。我的研究见解将改进射频消融术的实践指南，并可能最终消除偶然发现的小型肾肿瘤患者的手术需要。