scholarly journals A randomized controlled trial of amyloid positron emission tomography results disclosure in mild cognitive impairment

2020 ◽  
Vol 16 (9) ◽  
pp. 1330-1337
Author(s):  
Jennifer H. Lingler ◽  
Susan M. Sereika ◽  
Meryl A. Butters ◽  
Ann D. Cohen ◽  
William E. Klunk ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Randomized Controlled Trial ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Controlled Trial ◽  
Emission Tomography ◽  
Amyloid Positron Emission Tomography ◽  
Randomized Controlled ◽  
Positron Emission ◽  
Results Disclosure

Randomized Controlled Trial of the Role of Positron Emission Tomography in the Management of Stage I and II Non-Small-Cell Lung Cancer

2004 ◽  
Vol 22 (12) ◽  
pp. 2357-2362 ◽  
Author(s):  
Rosalie C. Viney ◽  
Michael J. Boyer ◽  
Madeleine T. King ◽  
Patricia M. Kenny ◽  
Christine A. Pollicino ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Small Cell ◽  
Stage I ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Randomized Controlled ◽  
Positron Emission

Purpose Positron emission tomography (PET) is a costly new technology with potential to improve preoperative evaluation for patients with non–small-cell lung cancer (NSCLC). There is increasing pressure for PET to be included in standard diagnostic work-up before decisions about surgical management of NSCLC. The resource implications of its widespread use in staging NSCLC are significant. Methods A randomized controlled trial was conducted to investigate the impact of PET on clinical management and surgical outcomes for patients with stage I-II NSCLC. The primary hypothesis was that PET would reduce the proportion of patients with stage I-II NSCLC who underwent thoracotomy by at least 10% through identification of patients with inoperable disease. Results One hundred eighty-four patients with stage I-II NSCLC were recruited and randomly assigned; 92% had stage I disease. Following exclusion of one ineligible patient, 92 patients were assigned to no PET and 91 to PET. Compared with conventional staging, PET upstaged 22 patients, confirmed staging in 61 and staged two patients as benign. Stage IV disease was rarely detected (two patients). PET led to further investigation or a change in clinical management in 13% of patients and provided information that could have affected management in a further 13% of patients. There was no significant difference between the trial arms in the number of thoracotomies avoided (P = .2). Conclusion For patients who are carefully and appropriately staged as having stage I-II disease, PET provides potential for more appropriate stage-specific therapy but may not lead to a significant reduction in the number of thoracotomies avoided.

scholarly journals Cost-effectiveness of using amyloid positron emission tomography in individuals with mild cognitive impairment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Young-Sil Lee ◽  
HyunChul Youn ◽  
Hyun-Ghang Jeong ◽  
Tae-Jin Lee ◽  
Ji Won Han ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cost Effectiveness ◽  
Emission Tomography ◽  
Sensitivity Analyses ◽  
Amyloid Pet ◽  
Amyloid Positron Emission Tomography ◽  
Positron Emission ◽  
The Cost

Abstract Background Amyloid positron emission tomography (PET) makes it possible to diagnose Alzheimer’s disease (AD) in its prodromal phase including mild cognitive impairment (MCI). This study evaluated the cost-effectiveness of including amyloid-PET for assessing individuals with MCI. Methods The target population was 60-year-old patients who were diagnosed with MCI. We constructed a Markov model for the natural history of AD with the amyloid positivity (AP). Because amyloid-PET can detect the AP MCI state, AD detection can be made faster by reducing the follow-up interval for a high-risk group. The health outcomes were evaluated in quality-adjusted life years (QALYs) and the final results of cost-effectiveness analysis were presented in the form of the Incremental Cost-Effectiveness Ratio (ICER). To handle parameter uncertainties, one-way sensitivity analyses for various variables were performed. Results Our model showed that amyloid-PET increased QALYs by 0.003 in individuals with MCI. The estimated additional costs for adopting amyloid-PET amounted to a total of 1250 USD per patient when compared with the cost when amyloid-PET is not adopted. The ICER was 3,71,545 USD per QALY. According to the sensitivity analyses, treatment effect of Donepezil and virtual intervention effect in MCI state were the most influential factors. Conclusions In our model, using amyloid-PET at the MCI stage was not cost-effective. Future advances in management of cognitive impairment would enhance QALYs, and consequently improve cost-effectiveness.

Sign in / Sign up

Export Citation Format

Share Document