Table 4. Sensitivity analyses on cost-effectiveness (cost per QALY gained) of using AABT versus CT surveillance alone for early diagnosis of lung cancer in patients who have incidentally detected pulmonary nodules, are at intermediate risk, and were scheduled for CT surveillance alone.
| Sensitivity / Specificity of AABT | ||
|---|---|---|
| 41% / 93% | 28% / 98% | |
| Basecase | $24,330 | $24,833 |
| Prevalence of Lung Cancer (basecase = 9.5%) | ||
| 3.0% | $90,973 | $83,880 |
| 12.0% | $18,821 | $19,479 |
| Distribution of Malignant Nodules at Detection (basecase = 100% local) | ||
| 87.5% local / 12.5% regional | $27,994 | $28,444 |
| Cost of AABT (basecase = $575) | ||
| $124 | $12,773 | $8,423 |
| $325 | $17,923 | $15,737 |
| $450 | $21,127 | $20,285 |
| $750 | $28,814 | $31,201 |
| Cost of CT (basecase = $245) | ||
| $500 | $24,989 | $25,019 |
| $1,500 | $27,575 | $25,749 |
| Sensitivity—AABT (basecase = 41% / 28%) | ||
| 20% | $52,956 | $35,078 |
| 30% | $33,952 | $23,143 |
| 40% | $24,974 | $17,266 |
| 50% | $19,743 | $13,768 |
| Specificity—AABT (basecase = 93% / 98%) | ||
| 90% | $29,107 | $44,300 |
| 100% | $13,994 | $20,485 |
| Tumor Doubling Time (basecase = 5.3 months) | ||
| 3.8 months | $18,663 | $19,265 |
| 7.4 months | $31,360 | $31,560 |
| Probability of Disease Progression* (basecase = 55.3%) | ||
| 33.6% | $61,501 | $59,997 |
| 79.1% | $12,331 | $12,777 |
| Overdiagnosis Bias (basecase = 18%) | ||
| 13.0% | $22,875 | $23,391 |
| 23.0% | $25,982 | $26,476 |
| Cost of Diagnostic Follow-Up (basecase = $5,415) | ||
| $4,061 | $22,132 | $23,942 |
| $6,769 | $26,528 | $25,725 |
| Cost of Lung Cancer Treatment (basecase = $36,724) | ||
| $27,543 | $24,287 | $24,792 |
| $45,905 | $24,373 | $24,875 |
| Stage 1 = $27,543 / Stage 4 = $45,905 | $23,677 | $24,266 |
| CT Screening Schedule (basecase = 4, 10, 21 months) | ||
| 3, 9, 24 months | $21,224 | $21,649 |
AABT, autoantibody test; CT, computed tomography; NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer
*During 2-year follow-up