Table 3.
Methodological characteristics of the included studies
| Authors | Unit costs | Type of economic evaluation | Model | Model assumptions | Perspective | Time horizon | Discount rate (%) |
|---|---|---|---|---|---|---|---|
| Alberts et al. [36] | $, 2014 | CUA | DAM, decision tree, Markov model | (a) In the absence of RCTs data, relative risk reduction was set according to the NCCN guidelines | Healthcare system perspective | Lifetime | 3 |
| Barone et al. [34] | €, 2012 | CUA | DAM | (a) The level of risk of developing metastatic disease was set at the level of 1 patients out of 2, 1/3, 1/4, 1/5 and 1/10 | Healthcare system perspective | NR | NR |
| Barzi et al. [17] | $, NR | CEA | Decision tree, Markov model | (a) The first-degree relatives of probands were considered as the healty individuals affected with LS who would be offered preventive measures | Societal perspective | Lifetime | NR |
| Behl et al. [33] | $, 2010 | CEA | Markov model | (a) The difference in survivals among alternatives and the referent strategy (1) depends exclusively on a lack of response to (1) | Healthcare system perspective | 10 years | 3 |
| Blank et al. [31] | €, 2010 | CUA | Markov model | (a) A high number of assumptions related to the composition of the patient population | Healthcare system perspective | Lifetime | 3 |
| Dinh et al. [27] | $, 2009 | CUA | Cohort simulation model | (a) Single-site testing only offered to FDRs of probands | Societal perspective | NR | 3 |
| Gallego et al. [18] | $, 2014 | CUA | Decision tree | (a) Assumptions relying on the population involved in the model. Firstly, only FDRs have been considered, then universal screening has been evaluated | Healthcare system perspective | Lifetime | 3 |
| Gausachs et al. [19] | €, NR | CEA | Decision tree | (a) Assumptions related to the prevalence of germline mutation | Healthcare system perspective | NR | NR |
| Gould-Suarez et al. [20] | $, NR | CEA | Decision tree | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | NR | NR |
| Gudgeon et al. [21] | $, 2010 | CEA | DAM | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | NR | NR |
| Ladabaum et al. [28] | $, 2010 | CEA | Decision tree with Markov subtrees | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | Lifetime (or 100 years) | 3 |
| Leenen et al. [22] | €, 2013 | CEA | DAM | (a) Assumptions made on uncertain parameters such as CRC risk for LS carriers, the method and risk reduction of LS surveillance and assumed adherence to LS surveillance programs | Healthcare system perspective | NR | 3 |
| Severin et al. [23] | €, 2012 | CEA | DAM, decision tree, Markov model | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | Lifetime (or 120 years) | 3 |
| Sie et al. [24] | €, 2013 | CEA | DAM, decision tree, Markov chain analysis | Assumptions on the estimated model such as on the baseline prevalence of LS and other factors. All values were derived from published literature | Healthcare system perspective | 30 years | 4 |
| Snowsill et al. [26] | £, 2013/14 | CUA | DAM, decision tree | (a) In the absence of RCTs data, estimates were sought from clinical experts | Healthcare system perspective | Lifetime (or 100 years) | 3.5 |
| Snowsill et al. [25] | £, 2013–14 | CUA | Decision tree, individual patient simulation model | The rate of acceptance of a test was independent of any previous tests, and acceptance of one genetic test implied acceptance of all genetic testing | Healthcare system perspective | Lifetime | 3.5 |
| Vijayaraghavan et al. [32] | $ and €, 2009 | CEA | Markov model | (a) Patients with KRAS mutant tumors received no benefit from EGFR inhibitors; (b) patients with KRAS mutant tumors received some benefit from combination therapy containing FOLFIRI or irinotecan; (c) KRAS mutation testing has a sentitivity of 95% and a specifity of 100%; (d) effectivess of cetuximab + FOLFIRI was equivalent to the effectiveness of cetuximab + Irinotecan | Healthcare system perspective | Lifetime | NR |
| Wang et al. [29] | $, 2010 | CUA | DAM, Decision tree, Markov subtrees | Different clinical management programs and acceptance rates among probands and relatives until age 75 years based on their germline testing results and cancer risk were modeled | Healthcare system perspective | Lifetime | 3 |
| Wang et al. [30] | SGD, 2010 | CEA | DAM, Decision tree, Markov subtrees | Related to compliance rates | Healthcare system perspective | Lifetime | 3 |
| Westwood et al. [35] | £, 2011 | CUA | Decision tree, Markov model | (a) Assumption of equal prognostic value analysis for all tests for which information on technical performance was available from the online survey; (b) the differences between the outcomes of evaluated trials are exclusively caused by the different tests used; (c) test accuracy based on objective response can be compared with accuracy based on resection rates | Healthcare system perspective | Lifetime | 3.5 |
DAM decision analytic model, NR not reported, RCTs randomized clinical trials, NCCN National Comprehensive Cancer Network, LS Lynch syndrome, FDRs first-degree-relatives, CRC colorectal cancer, CEA cost-effectiveness analysis, CUA cost-utility analysis