Mp36-15 Cost-Effectiveness Analysis of the Clear Cell Likelihood Score Against Renal Mass Biopsy for Evaluating Small Renal Masses

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance I (MP36) 1 May 2024MP36-15 COST-EFFECTIVENESS ANALYSIS OF THE CLEAR CELL LIKELIHOOD SCORE AGAINST RENAL MASS BIOPSY FOR EVALUATING SMALL RENAL MASSES Katherina Y. Chen, Moritz J. Lange, Jessica X. Qiu, Drew Lambert, Ayman Mithqal, Tracey L. Krupski, Noah S. Schenkman, and Jennifer M. Lobo Katherina Y. ChenKatherina Y. Chen, Moritz J. LangeMoritz J. Lange, Jessica X. QiuJessica X. Qiu, Drew LambertDrew Lambert, Ayman MithqalAyman Mithqal, Tracey L. KrupskiTracey L. Krupski, Noah S. SchenkmanNoah S. Schenkman, and Jennifer M. LoboJennifer M. Lobo View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001008612. 93052. 9d. 15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Increasing use of cross-sectional imaging has increased the incidental discovery of small renal masses (SRMs). Though SRMs usually have a low metastatic potential, clear cell renal cell carcinoma (ccRCC) has a high potential for an aggressive phenotype. The ability to identify the subtype could expedite treatment of high-risk patients. The clear cell likelihood score (ccLS), a grading system based on multiparametric magnetic resonance imaging that assigns the mass a score of 1 to 5, has been proposed as a possible alternative to percutaneous renal mass biopsy (RMB) for differentiating ccRCC. As healthcare systems continue to emphasize value-based care, it is important to assess the cost-effectiveness of new diagnostic modalities to optimize resource allocation and improve patient outcomes. The objective of this study is to examine the cost-effectiveness of evaluating SRMs with the ccLS compared to RMB alone. METHODS: Decision analysis was performed using TreeAge software. Costs were obtained from institutional fees and Medicare reimbursement rates. Probabilities were derived from literature estimates performed by ccLS-trained radiologists. All patients in the RMB branch undergo biopsy while in the ccLS branch, only patients that received an indeterminant ccLS of 3 undergo biopsy. Effectiveness was assigned a value of 1 for the correct diagnosis and a value of 0 for an incorrect or indeterminant diagnosis. RESULTS: In the base case model, the ccLS was both more effective (0. 78 vs. 0. 72) and less expensive than RMB, with an average of 337. 81 less for patients evaluated with the ccLS (1628. 59) as compared to patients undergoing RMB (1, 966. 40). Sensitivity analysis showed that the RMB nondiagnostic rate and the sensitivity of the ccLS had the greatest impact on the model. In threshold analyses, the ccLS was the preferred strategy when the ccLS sensitivity was greater than 62. 7% and when the cost of MRI was less than 5332. 43. CONCLUSIONS: The ccLS was a more cost-effective option than RMB alone for evaluating SRMs for ccRCC. Utilization of the ccLS in guiding clinical decision-making for SRMs can lead to significant cost savings in addition to preventing patients from undergoing an invasive procedure and assuming its associated risks. Given the high impact of ccLS sensitivity on effectiveness, future research is needed on how the ccLS performs in a broader population of radiologists. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e598 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Katherina Y. Chen More articles by this author Moritz J. Lange More articles by this author Jessica X. Qiu More articles by this author Drew Lambert More articles by this author Ayman Mithqal More articles by this author Tracey L. Krupski More articles by this author Noah S. Schenkman More articles by this author Jennifer M. Lobo More articles by this author Expand All Advertisement PDF downloadLoading. . .