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Table 4 Scenario analyses – effect of model assumptions on quality-adjusted life days (QALDs) gained versus no screening

From: Benefits and harms of prostate cancer screening – predictions of the ONCOTYROL prostate cancer outcome and policy model

 

One-time screening at age

Interval screening at age 55–59, with interval

Interval screening at age 55–64, with interval

Interval screening at age 55–69, with interval

55y

59y

64y

69y

4y (2 x)

2y (3 x)

1y (5 x)

4y (3 x)

2y (5 x)

1y (10 x)

4y (4 x)

2y (8 x)

1y (15 x)

Predictions for men average PCa risk

Base-case result

−1.3

−2.3

−3.9

−7.2

−2.8

−3.5

−4.4

−4.9

−5.8

−6.7

−7.3

−10.6

−11.2

  Perioperative RP mortality (base case = 0.0015)

             

  None

−1.2

−2.1

−3.7

−6.9

−2.5

−3.2

−4.1

−4.5

−5.3

−6.2

−6.7

−9.8

−10.3

  Duration of disutility due to treatment complications (base case = 5 years)

             

  1 year

−0.6

−1.2

−1.9

−4.1

−1.2

−1.7

−2.3

−2.2

−2.5

−2.5

−3.0

−4.3

−3.9

  One-time utility decrements (base case = age- and state-specific decrements)

             

  50% reduction of decrements

−0.6

−1.3

−2.2

−4.6

−1.3

−1.7

−2.2

−2.4

−2.7

−2.4

−3.4

−4.9

−4.1

  Utility for non-symptomatic health states (base case = age-specific)

             

  Utility = 1

−1.3

−2.5

−4.1

−8.1

−2.8

−3.6

−4.6

−5.0

−5.8

−6.4

−7.3

−10.5

−10.5

Predictions for men with elevated familial PCa risk

Base-case result

1.8

1.7

0.3

−3.9

3.6

4.6

5.5

4.7

7.1

10.6

5.1

8.2

13.0

  Perioperative RP mortality (base-case = 0.0015)

             

  None

1.9

1.9

0.6

−3.6

3.9

4.9

5.8

5.1

7.6

11.3

5.7

9.1

14.1

  Duration of disutility due to treatment complications (base case = 5 years)

             

  1 year

2.6

3.1

2.6

−0.6

5.4

6.7

8.0

7.8

10.9

15.8

10.0

15.6

21.9

  One-time utility decrements (base case = age- and state-specific decrements)

             

  50% reduction of decrements

2.6

3.0

2.4

−0.9

5.3

6.7

8.0

7.6

10.7

15.7

9.6

14.9

21.3

  Utility for non-symptomatic health states (base case = age-specific utility)

             

  Utility = 1

2.6

2.7

1.6

−3.4

5.2

6.7

8.0

7.4

10.8

16.1

8.9

14.4

21.6

  Effect of familial risk factor (base case = increase of PCa onset and progression)

             

  Increase of PCa onset only

−2.3

−5.8

−13.1

−22.0

−5.2

−5.5

−5.3

−9.5

−8.3

−9.0

−17.0

−21.6

−19.0

  Increase of PCa progression only

2.2

2.7

2.4

0.0

4.8

6.0

7.1

7.3

10.1

14.8

9.5

14.7

20.6

  1. Results are based on individual level simulation (microsimulation) with 10 million trials. Time horizon = 120 years, Compliance = 100%. PCa prostate cancer, RP radical prostatectomy
  2. QALDs were primary benefit-harm outcome was indicated in bold