CT Scan Cost-Effective Way to Screen for Lung Condition

High-resolution CT scans diagnose pulmonary LAM early in young women

THURSDAY, March 10 (HealthDay News) -- Using high-resolution computed tomography (HRCT) to screen nonsmoking young women who spontaneously suffer a pneumothorax is a cost-effective strategy for the early diagnosis of pulmonary lymphangioleiomyomatosis (LAM), according to a study published online Feb. 18 in the American Journal of Respiratory and Critical Care Medicine.

Jared T. Hagaman, M.D., of the University of Cincinnati, and colleagues developed a Markov model to assess the cost-effectiveness of screening with HRCT based on published incidence rates for pneumothorax, LAM prevalence in the 25 to 54 age group of women, and costs of testing and treatment from 2007 Medicare data. They used the model to analyze the costs of HRCT screening, early diagnosis, and treatment (pleurodesis) compared to the costs of no HRCT screening and deferred diagnosis and treatment.

The analysis found that HRCT screening for LAM delivered a marginal cost-effectiveness ratio of $32,980 per quality-adjusted life-year gained. Further, a sensitivity analysis demonstrated that HRCT screening remained cost-effective for any population in which LAM prevalence is greater than 2.5 percent, about half the 5-percent LAM prevalence rate the researchers derived from published medical literature.

"In conclusion, through the use of decision modeling techniques, we have shown that HRCT screening for LAM in nonsmoking women age 25 to 54 who present with spontaneous pneumothorax is cost-effective. As a result, primary care providers and emergency medicine physicians treating this population are advised to consider obtaining a HRCT in this patient population," the authors write.

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