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Research Article| Volume 19, ISSUE 4, P757-771, December 1999

Cost-Effectiveness Analysis in Pathology

  • Stephen S. Raab
    Correspondence
    Address reprint requests to: Stephen S. Raab, MD, Department of Pathology and Laboratory Medicine, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212
    Affiliations
    From the Department of Pathology and Laboratory Medicine, Center for Clinical Effectiveness and Outcomes Research, Allegheny General Hospital, Medical College of Pennsylvania and Hahnemann University, Pittsburgh, Pennsylvania
    Search for articles by this author
DOI:https://doi.org/10.1016/S0272-2712(18)30088-X
Cost-Effectiveness Analysis in Pathology
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      Cost-effectiveness analysis has become increasingly important in all areas of medicine. This article provides an overview of cost- effectiveness analysis, the limitations of cost-effectiveness analyses in the current anatomic pathology literature, and the benefits of performing cost-effectiveness analysis. The standards of good cost-effectiveness studies and a detailed evaluation of an anatomic pathology cost-effectiveness article are also discussed.
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      References

        • Albert A.
        • Gertman P.
        • Louis T.
        Screening for the early detection of cancer. I. The temporal natural history of a progressive disease state.
        Math Biosci. 1978; 40: 1-59
        • Albert A.
        • Gertman P.
        • Louis T.
        • et al.
        Screening for the early detection of cancer. II. The impact of screening on the natural history of the disease.
        Math Biosci. 1978; 40: 61-109

      3. Baker MS, Kessler LG, Smucker RC: Analysis of the continuous Medicare history sample file: The cost of treating cancer. In Proceedings of Cancer Care and Costs, a meeting of the American Cancer Society. San Diego, May 1987

        • Bethesda Committee
        The Bethesda System for Reporting Cervical/Vaginal Diagnoses. Springer-Verlag, New York1994
        • Brown A.D.
        • Garber A.M.
        Cost-effectiveness of 3 methods to enhance the sensitivity of Papanicolaou testing.
        JAMA. 1999; 281: 347-353
        • Carr-Hill R.A.
        Background material for the workshop on QALYs.
        Soc Sci Med. 1989; 3: 469-477
        • Chassin M.R.
        • Brook R.H.
        • Park R.E.
        • et al.
        Variations in the use of medical and surgical services by the Medicare population.
        N Engl J Med. 1986; 314: 285-290
        • Chassin M.
        • Kosecoff J.
        • Park R.E.
        • et al.
        Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures.
        JAMA. 1987; 258: 2533-2537
        • Clarke E.A.
        • Anderson T.W.
        Does screening by “Pap” smears help prevent cervical cancer? A case-control study.
        Lancet. 1979; 2: 1-4
        • Day N.E.
        Effect of cervical cancer screening in Scandinavia.
        Obstet Gynecol. 1984; 63: 714-718
        • Detsky A.S.
        • Naglie I.G.
        A clinician’s guide to cost-effectiveness analysis.
        Ann Intern Med. 1990; 113: 147-154
        • Doubilet P.
        • Weinstein M.C.
        • McNeil B.J.
        Use and misuse of the term “cost-effective” in medicine.
        N Engl J Med. 1986; 314: 253-256
      13. Economic Report of the President. US Government Printing Office, Washington1997
        • Eddy D.M.
        Screening for cervical cancer.
        Ann Intern Med. 1990; 113: 214-226
        • Farrow D.C.
        • Hunt W.C.
        • Samet J.M.
        Geographic variation in the treatment of localized breast cancer.
        N Engl J Med. 1992; 326: 1097-1101
        • Finkler S.A.
        The distinction between cost and charges.
        Ann Intern Med. 1982; 96: 102-109
        • Froberg D.G.
        • Kane R.L.
        Methodology for measuring health-state preferences-II: Scaling methods.
        J Clin Epidemiol. 1989; 42: 459-471
        • Guyatt G.H.
        • Veldhuyzen Van Zanten S.J.
        • Feeny D.H.
        • Patrick D.L.
        Measuring quality of life in clinical trials: A taxonomy and review.
        Can Med Assoc J. 1989; 140: 1441-1448
        • Hillman B.J.
        • Joseph C.A.
        • Mabry M.R.
        • et al.
        Frequency and costs of diagnostic imaging in office practice-a comparison of self-referring and radiologist-referring physicians.
        N Engl J Med. 1990; 323: 1604-1608
        • Hollen P.J.
        • Gralla R.J.
        • Kris M.G.
        • et al.
        Measurement of quality of life in patients with lung cancer in multicenter trials of new therapies.
        Cancer. 1994; 73: 2087-2098
        • Johnson N.
        • Sutton J.
        • Thornton J.G.
        • et al.
        Decision analysis for best management of mildly dyskaryotic smear.
        Lancet. 1993; 342: 91-96
        • Kaplan R.M.
        Quality of life assessment for cost/utility studies in cancer.
        Cancer Treat Rev. 1993; 19: 85-96
        • Koss L.G.
        • Lin E.
        • Schreiber K.
        • et al.
        Evaluation of the Papnet cytologic screening system for quality control of cervical smears.
        Am J Clin Pathol. 1994; 101: 220-229
        • Laupacis A.
        • Feeny D.
        • Detsky A.S.
        • et al.
        Tentative guidelines for using clinical and economic evaluations revisited.
        Can Med Assoc J. 1993; 148: 927-929
        • Leaf A.
        Cost effectiveness as a criterion for Medicare coverage. Sounding board.
        N Engl J Med. 1989; 321: 989-990
        • Lipscomb J.
        Time preference for health in cost-effectiveness analysis.
        Med Care. 1989; 27: S233-252
        • Loomes G.
        • McKenzie L.
        The use of QALYs in health care decision making.
        Soc Sci Med. 1989; 28: 299-308
        • Luce B.
        • Manning W.
        • Siegel J.
        • Lipscomb J.
        Estimating costs in cost-effectiveness analysis.
        in: Gold M. Siegel J. Russell L. Weinstein M. Cost-effectiveness in Health and Medicine. Oxford University Press, New York1996: 176-213
        • Mandelblatt J.
        • Freeman H.
        • Winczewski D.
        • et al.
        The costs and effects of cervical and breast cancer screening in a public hospital emergency room.
        Am J Public Health. 1997; 87: 1182-1189
        • Mehrez A.
        • Gafni A.
        Quality-adjusted life years, utility theory, and healthy-years equivalents.
        Med Decis Making. 1989; 9: 142-149
        • Miller A.B.
        Screening for cancer: Issues and future directions.
        J Chronic Dis. 1986; 39: 1067-1077
        • Morreim E.H.
        Conflicts of interest: Profits and problems in physician referrals.
        JAMA. 1989; 262: 390-394
        • Nattinger A.B.
        • Gottlieb M.S.
        • Veum J.
        • et al.
        Geographic variation in the use of breast-conserving treatment for breast cancer.
        N Engl J Med. 1992; 326: 1102-1107
        • Naylor C.D.
        • Williams H.I.
        • Basinski A.
        • et al.
        Technology assessment and cost-effectiveness analysis: Misguided guidelines?.
        Can Med Assoc J. 1993; 148: 921-924

      35. NeoPath: AutoPap 300 QC Automatic Pap Screener System (product insert). Redmond, WA, NeoPath, 1996, p 10

        • Netser J.C.
        • Robinson R.A.
        • Smith R.J.
        • et al.
        Value-based pathology: A cost-benefit analysis of the examination of routine and nonroutine tonsil and adenoid specimens.
        Am J Clin Pathol. 1997; 108: 158-165
        • Novis D.A.
        • Gephardt G.N.
        • Zarbo R.J.
        Interinstitutional comparison of frozen section consultation in small hospitals.
        Arch Pathol Lab Med. 1996; 120: 1087-1093
        • Novis D.A.
        • Zarbo R.J.
        Interinstitutional comparison of frozen section turnaround time.
        Arch Pathol Lab Med. 1997; 121: 559-567
        • O’Leary T.
        • Tellado M.
        • Buckner S-B.
        • et al.
        Papnet-assisted rescreening of cervical smears: Cost and accuracy compared with 100% manual rescreening strategy.
        JAMA. 1998; 279: 235-237
        • Östör A.G.
        Natural history of cervical intraepithelial neoplasia: A critical review.
        Int J Gynecol Pathol. 1993; 12: 186-192
        • Pilote L.
        • Califf R.M.
        • Sapp S.
        • et al.
        Regional variation across the United States in the management of acute myocardial infarction.
        N Engl J Med. 1995; 333: 565-572
        • Raab S.S.
        The cost-effectiveness of cervical-vaginal rescreening.
        Am J Clin Pathol. 1997; 108: 525-536
        • Raab S.S.
        The cost-effectiveness of routine histologic examination.
        Am J Clin Pathol. 1998; 110: 391-396
        • Raab S.S.
        • Hornberger J.
        The effect of a patient’s risk-taking attitude on the cost-effectiveness of testing strategies in the evaluation of pulmonary lesions.
        Chest. 1997; 111: 1583-1590
        • Raab S.S.
        • Slagel D.D.
        • Robinson R.A.
        The utility of the histologic examination of tissue removed during elective joint replacement: A preliminary assessment.
        J Bone Joint Surg Am. 1998; 80A: 331-335
        • Raab S.S.
        • Steiner A.L.
        • Hornberger J.
        The cost-effectiveness of treating women with a cervical vaginal smear diagnosis of atypical squamous cells of undetermined significance.
        Am J Obstet Gynecol. 1998; 179: 411-420
        • Raab S.S.
        • Zaleski M.S.
        • Silverman J.F.
        The cost-effectiveness of the cytology laboratory and new cytology technologies in cervical cancer prevention.
        Am J Clin Pathol. 1999; 109: 259-266
        • Roberts J.
        • Gurley A.
        • Thurloe J.
        • et al.
        Evaluation of the ThinPrep test as an adjunct to the conventional Pap smear.
        Med J Aust. 1997; 167: 466-469
        • Roper W.L.
        • Winkenwerder W.
        • Hackbarth G.M.
        • Krakauer H.
        Effectiveness in health care: An initiative to evaluate and improve medical practice.
        N Engl J Med. 1988; 319: 1197-1202
        • Russell L.B.
        Some of the tough decisions required by a national health plan.
        Science. 1989; 246: 892-896
        • Schroeder S.A.
        • Showstack J.A.
        Financial incentives to perform medical procedures and laboratory tests: Illustrative models of office practice.
        Med Care. 1978; 16: 289-298
        • Siegel J.
        • Weinstein M.
        • Torrance G.
        Reporting cost-effectiveness studies and results.
        in: Gold M. Siegel J. Russell L. Weinstein M. Cost-effectiveness in Health and Medicine. Oxford University Press, New York1996: 276-303
        • Torrance G.W.
        Measurement of health state utilities for economic appraisal: A review.
        J Health Econ. 1986; 5: 1-30
        • Udvarhelyi I.S.
        • Colditz G.A.
        • Rai A.
        • Epstein A.M.
        Cost-effectiveness and cost-benefit analyses in the medical literature.
        Ann Intern Med. 1992; 116: 238-244
        • van der Graff Y.
        • Zielhuis G.A.
        • Peer P.G.
        • Vooijs P.G.
        The effectiveness of cervical screening: A population-based case-control study.
        J Clin Epidemiol. 1988; 41: 21-26
        • Weinstein M.C.
        Challenges for cost-effectiveness research.
        Med Decis Making. 1986; 6: 194-198
        • Weinstein M.C.
        • Siegel J.E.
        • Gold M.R.
        • et al.
        Recommendations of the panel on cost-effectiveness in health and medicine.
        JAMA. 1996; 276: 1253-1258
        • Wennberg J.
        • Gittelsohn A.
        Small area variations in health care delivery: A population-based health information system can guide planning and regulatory decision-making.
        Science. 1973; 182: 1102-1108

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      DOI: https://doi.org/10.1016/S0272-2712(18)30088-X

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      © 1999 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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