Cost-Effectiveness of Alternative Management Strategies for Patients with Solitary Pulmonary Nodules

Figure 1. The recommended sequence of tests when CT results are possibly malignant ( ) and when CT results are benign ( ) is shown. Subsequent test selection is shown to be a function of pretest probability and the corresponding post-test probability once the results of CT are known. Note that surgery is preferred when positron emission tomography (PET) results are positive, biopsy is preferred when PET results are negative, and watchful waiting is preferred when biopsy results are nondiagnostic. Recommendations are based on the assumption that society is willing to pay $100 000 per quality-adjusted life-year gained. Results were very similar when willingness to pay was assumed to be $25 000 or $50 000 per quality-adjusted life-year gained. FDG-PET = positron emission tomography with 18-fluorodeoxyglucose.
Figure 1. The recommended sequence of tests when CT results are possibly malignant ( ) and when CT results are benign ( ) is shown. Subsequent test selection is shown to be a function of pretest probability and the corresponding post-test probability once the results of CT are known. Note that surgery is preferred when positron emission tomography (PET) results are positive, biopsy is preferred when PET results are negative, and watchful waiting is preferred when biopsy results are nondiagnostic. Recommendations are based on the assumption that society is willing to pay $100 000 per quality-adjusted life-year gained. Results were very similar when willingness to pay was assumed to be $25 000 or $50 000 per quality-adjusted life-year gained. FDG-PET = positron emission tomography with 18-fluorodeoxyglucose. Recommended sequence of diagnostic testing in patients who are at average risk for surgical complications, according to pretest probability and the results of computed tomography (CT).topbottom

This Article

  1. Ann Intern Med May 6, 2003 vol. 138 no. 9 724-735
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