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CT-scan screening for LAM in women with collapsed lung is cost-effective
Date:3/4/2010

on CT screening following lung collapse for patients with LAM to no CT screening. Costs of testing and treatment were taken from 2007 Medicare data.

About five percent of women who fit the "model patient" profilea 30-year old, nonsmoking woman who comes into the emergency room with a spontaneous lung collapsetest positive for LAM.

"Screening for LAM using a high-resolution CT, or three-dimensional X-ray of the lungs, is the most cost-effective strategy, with approximately $32,000 per quality-adjusted life year gained," said Dr. Kinder. "For comparison, hemodialysis, a standard benchmark for cost-effectiveness, costs about $50,000 per quality-adjusted life year gained. With this data, physicians will be able to intervene with therapies more quickly and enroll patients in clinical trials that may be able to slow progression of the disease."

Furthermore, Dr. Kinder pointed out, high-resolution CT screening adds a low amount of risk to the LAM-negative population with respect to added radiation. "We believe the benefits of testing outweigh any negative impact on patients without LAM. Additionally, there will be benefits of high-resolution CT scanning for those with diagnoses of lung diseases other than LAM (such as Langerhans Cell Histocytosis, lymphocytic interstitial pneumonitis and others). The radiation dose of high-resolution CT scans is approximately one-tenth that of conventional CT scans, and with newer technology the radiation exposure continues to decrease."

Due to the sudden nature of pneumothoraces, and their relative rarity, a prospective study in this population is not feasible. But the current findings may have immediate bearing on current clinical practices.

"We believe that this study is a useful example of the utility of modern decision analysis techniques to answer important questions in comparative effectiveness research. We believe that this study may change current best practices; particularly if we are
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Contact: Keely Savoie
212-315-8620
American Thoracic Society
Source:Eurekalert

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