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：
7740533
负责人：
Pari Vijay Pandharipande
金额：
$ 17.87万
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/7740533
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 Image Incidence Indolent Intervention Kidney Neoplasms Literature Living Costs 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 Research Priority 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 effectiveness economic outcome health economics improved insight interest markov model minimally invasive multidisciplinary neoplasm registry oncology 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与手术与当前的护理标准进行比较，确定最小侵入性疗法的临床作用 - 经皮射频消融（RFA）。 1将使用决策分析方法实现这一目标。首先，我将根据文献和SEER癌症注册表的数据开发一个计算机模型来估计RFA和手术的长期有效性，该模型模拟了偶然检测到的肾脏肿瘤的自然历史。其次，我将分别收集患者数据，以改善与RFA和手术相关的生活质量和成本估计 - 这些估计值在文献中不可用或不充分报告到日期。第三，我将进行成本效益分析，其中我将使用获得的有效性，生活质量和成本数据将RFA与手术进行比较。最后，我将执行广泛的概率灵敏度分析，以估计与分析结果相关的不确定性。我的职业目标是通过确定基于成像的技术在癌症患者中的最佳作用来改善癌症的结果。我追求了一条独特的职业道路，将癌症成果研究，决策分析和放射学结合起来。我是临床部门的一部分，该部门是肾脏肿瘤RFA的大型推荐中心，并且有大量资源来支持决策分析研究的结果研究所。我已经组建了一个决策科学，流行病学，放射学，泌尿外科，肿瘤学和病理学的多学科团队，目前在我的研究和职业发展中为我提供建议，并将在奖励期内继续这样做。我在该提案中概述的研究和职业发展计划将为我提供持续的肾脏肿瘤疗法评估的坚实基础，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的作用 - 一种微创肿瘤疗法 - 在治疗小的，偶然检测到的肾脏肿瘤中。我的研究中的见解将改善使用射频消融的实践指南，并最终可能排除小型，偶然检测到的肾脏肿瘤患者进行手术的需求。