MRI for Prostate Cancer Triage in Primary Care: Early Economic Evaluation

What is it about?

The study explores the potential impacts of incorporating prebiopsy magnetic resonance imaging (MRI) into primary care as a triage test within the prostate cancer diagnostic pathway. Decision analytic modelling with decision trees was used for this early economic evaluation. The model was developed reflecting the common primary care routes to diagnosis for prostate cancer: opportunistic, asymptomatic prostate-specific antigen (PSA) screening or symptomatic presentation. The use of multiparametric MRI (mpMRI) or biparametric MRI (bpMRI) as a primary care triage test following an elevated PSA result was evaluated. A health system perspective was adopted with a time horizon of 12 months. The study found that using prostate MRI as a second-level triage test for suspected prostate cancer in primary care could reduce health service costs without a detrimental effect on patient utility.

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Why is it important?

This research is important because it explores the potential impacts of incorporating prebiopsy magnetic resonance imaging (MRI) into primary care as a triage test within the prostate cancer diagnostic pathway. The use of MRI as a primary care triage test following an elevated PSA result was evaluated in this study, which can potentially improve the efficiency and effectiveness of the diagnostic process for prostate cancer. The findings of this study can inform the design of clinical pathways by NHS commissioners and cancer alliances, leading to better patient outcomes and cost savings. Key Takeaways: 1. The study used decision analytic modelling with decision trees to evaluate the impact of incorporating prebiopsy MRI into primary care as a triage test for prostate cancer. 2. The model showed that the PSA-based prostate cancer diagnostic pathways were dominated by both mpMRI- and bpMRI-based pathways for patients undergoing opportunistic screening and symptomatic assessment. 3. Using MRI as a second-level triage test for suspected prostate cancer in primary care could reduce health service costs without a detrimental effect on patient utility. 4. The study highlights the potential benefits of integrating MRI into the existing prostate cancer diagnostic pathway, including increased detection of clinically significant prostate cancer and avoiding unnecessary biopsies.