Table 75Intensive testing for cancer – Economic study characteristics

StudyLimitationsApplicabilityOther comments
Di Nisio 200553Potentially serious limitations (a)Partially applicable (b)Within-trial analysis with modelled extrapolation based on a RCT192 included in our clinical review (0).
a

Breakdown of costs and other data input in the model (for example treatment success, probability of having a specific type of cancer) were not explicitly reported. Discounting was not reported. Effectiveness but not cost of cancer treatment was taken into account. Cost-effectiveness of investigations might depend on the absolute risk of cancer; this was not appropriately accounted for in the sensitivity analysis. The authors identified the following limitations: the RCT on which the analysis was based was stopped prematurely and included only 201 patients. The difference in mortality between patients who received investigations and patients who did not receive any was not significant. The sensitivity and specificity of the tests were really uncertain as they were based on few patients. Several assumptions on life expectancy in patients with cancer were made. Patients with thrombophilia were included in the RCT. Patients under the age of 25 were excluded. The risk due to radiation was not included in the analysis.

b

Study conducted in the Netherlands. QALYs were not estimated in the original study but the NCGC assumed people surviving had a utility equal to that of the general population in the UK (0.86).126

From: 13, Investigations for cancer in VTE patients

Cover of Venous Thromboembolic Diseases
Venous Thromboembolic Diseases: The Management of Venous Thromboembolic Diseases and the Role of Thrombophilia Testing [Internet].
NICE Clinical Guidelines, No. 144.
National Clinical Guideline Centre (UK).
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