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首页> 外文期刊>BMC Health Services Research >Is computer aided detection (CAD) cost effective in screening mammography? A model based on the CADET II study
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Is computer aided detection (CAD) cost effective in screening mammography? A model based on the CADET II study

机译：计算机辅助检测（CAD）在筛查乳房X线摄影术中是否有效？基于Cadet II研究的模型

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Background Single reading with computer aided detection (CAD) is an alternative to double reading for detecting cancer in screening mammograms. The aim of this study is to investigate whether the use of a single reader with CAD is more cost-effective than double reading. Methods Based on data from the CADET II study, the cost-effectiveness of single reading with CAD versus double reading was measured in terms of cost per cancer detected. Cost (Pound (￡), year 2007/08) of single reading with CAD versus double reading was estimated assuming a health and social service perspective and a 7 year time horizon. As the equipment cost varies according to the unit size a separate analysis was conducted for high, average and low volume screening units. One-way sensitivity analyses were performed by varying the reading time, equipment and assessment cost, recall rate and reader qualification. Results CAD is cost increasing for all sizes of screening unit. The introduction of CAD is cost-increasing compared to double reading because the cost of CAD equipment, staff training and the higher assessment cost associated with CAD are greater than the saving in reading costs. The introduction of single reading with CAD, in place of double reading, would produce an additional cost of ￡227 and ￡253 per 1,000 women screened in high and average volume units respectively. In low volume screening units, the high cost of purchasing the equipment will results in an additional cost of ￡590 per 1,000 women screened. One-way sensitivity analysis showed that the factors having the greatest effect on the cost-effectiveness of CAD with single reading compared with double reading were the reading time and the reader's professional qualification (radiologist versus advanced practitioner). Conclusions Without improvements in CAD effectiveness (e.g. a decrease in the recall rate) CAD is unlikely to be a cost effective alternative to double reading for mammography screening in UK. This study provides updated estimates of CAD costs in a full-field digital system and assessment cost for women who are re-called after initial screening. However, the model is highly sensitive to various parameters e.g. reading time, reader qualification, and equipment cost.
机译：背景技术单读计算机辅助检测（CAD）是在筛选乳房X光图中检测癌症的双重阅读的替代方案。本研究的目的是调查与CAD的单个读者是否比双读更具成本效益。方法基于CADET II研究的数据，在检测到每种癌症的成本方面测量了单读与双读数的单读的成本效益。假设健康和社会服务视角和7年的时间范围，估计单读与CAD与双重阅读的成本（镑（£），2007/08年）。由于设备成本根据单位尺寸而变化，因此对高，平均和低容量筛选单元进行了单独的分析。通过改变阅读时间，设备和评估成本，召回率和读者资格来执行单向敏感性分析。结果CAD对所有尺寸的筛选单元都成本增加。与双重阅读相比，CAD的引入是成本增加，因为CAD设备的成本，员工培训和与CAD相关的更高的评估成本大于阅读成本的节省。通过CAD引入单读，代替双重阅读，将分别在高平均和平均体积单位中筛选227英镑和253英镑的额外费用。在低音量筛选单元中，购买设备的高成本将额外成本为每1000名女性筛选的590英镑。单向敏感性分析表明，与双层阅读相比，对CAD成本效益最大的因素是阅读时间和读者的专业资格（放射科学表与高级从业者）。结论没有CAD效率的改善（例如，召回率的减少）CAD不太可能是在英国进行乳房X线摄影筛查的成本有效的替代方案。本研究规定了在初始筛选后重新调用的妇女的全场数字系统和评估成本的CAD成本的更新估计。然而，该模型对各种参数非常敏感。阅读时间，读者资格和设备成本。

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