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A Micro-Simulation Model of the Benefits and Costs of Prostate Cancer Screening and Treatment

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Annual rept. 1 Jul 1999-30 Jun 2000

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Our project is completing work on an innovative model to determine the cost-effectiveness of alternative prostate cancer screening strategies. Indeed, prostate cancer screening remains controversial and continues to present difficult choices for patients, physicians, and policy makers. Hence, modeling the natural history, screening, and treatment of prostate cancer to better understand screening benefits and costs is potentially of great value. To date, we have reviewed every published cost-effectiveness analysis of prostate cancer screening. While these papers have many strengths, all of them have flaws that undermine their validity and relevance. We have addressed these concerns extensively in the model we have developed. We have now finished programming the model and are currently fitting the model using constrained optimization and maximum likelihood techniques. We have also performed preliminary analyses of annual screening with digital rectal exam DRE, prostate specific antigen PSA, or their combination. These analyses suggest that screening may be cost-effective in terms of cost per life-year saved however, analyses in terms of cost per Quality Adjusted Life-Year QALY suggest that their cost-effectiveness is highly dependent on quality of life weights for health states. We will be finishing our analyses and preparing manuscripts for publication over the next few months.

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  • Economics and Cost Analysis
  • Anatomy and Physiology
  • Medical Facilities, Equipment and Supplies

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