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Adrenal Mass Evaluation in Patients with Lung Carcinoma

A Cost-Effectiveness Analysis

Erick M. Remer1, Nancy Obuchowski1,2, James D. Ellis1, Thomas W. Rice3, David J. Adelstein4 and Mark E. Baker1

1 Division of Radiology, The Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195-5103.
2 Departments of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, OH 44195-5103.
3 Department of Cardiothoracic Surgery, The Cleveland Clinic Foundation, Cleveland, OH 44195-5103.
4 Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation, Cleveland, OH 44195-5103.



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  		Fig. 1. —Decision tree shows different strategies to evaluate adrenal mass and outcomes for strategies. Possible combinations of CT, MR imaging, and biopsy result in different possible therapeutic options and health states. Three dots indicate continuation to subtree in lower right corner of figure, Ad. = adenoma, Met. = metastasis, Ben. = benign.

 


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  		Fig. 2. —Graph shows two-way sensitivity analysis for sensitivity of CT (10 H) and cost of MR imaging. Best strategy at each combination of variables is shown by decision boundary depicted by line. Note that uncertainty in our parameter estimates could affect selection of best strategy.

 

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