title: The Kallikrein Panel for prostate cancer screening: its economic impact.
abstract: BACKGROUND
  Current diagnostic testing for prostate cancer results in numerous unnecessary biopsy procedures and creates a substantial financial burden. A statistical prediction model for prostate cancer has been developed, based on four Kallikrein markers in blood. This systematic review and meta-analysis examines the aggregated results from published studies of the Kallikrein Panel.
  
  
  METHODS
  Literature searches to identify relevant studies were conducted. A meta-analysis of the results was performed using inverse variance, mean difference with corresponding 95% confidence intervals (CI). The results of the meta-analysis were used to assess the Kallikrein Panel's effect on healthcare costs.
  
  
  RESULTS
  The Kallikrein Panel has been evaluated in more than 8,500 patients (2,780 with prostate cancer and 598 with high grade prostate cancer). Meta-analysis demonstrates a statistically significant improvement of 8-10% in predictive accuracy. In addition, 48% to 56% of current prostate biopsies could be avoided. Use of the Kallikrein Panel could result in annual US savings approaching $1 billion.
  
  
  CONCLUSIONS
  The Kallikrein Panel has the potential to improve patient outcomes and reduce costs. The panel provides significantly improved specificity. Because the Kallikrein Panel has been studied in a range of clinical settings, it is a test that could be readily and widely used in practice.
authors.affiliation: Medical Device Consultants of Ridgewood, LLC, Ridgewood, New Jersey.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Voigt
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Zappala
authors.forename: E Darracott
authors.initials: ED
authors.lastname: Vaughan
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wein
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor / Q000097:blood* / Q000191:economics*; D001706:Biopsy / Q000191:economics; D017046:Cost Savings; D003365:Costs and Cost Analysis; D055088:Early Detection of Cancer / Q000191:economics; D006801:Humans; D007610:Kallikreins / Q000097:blood*; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood* / Q000191:economics*; D012680:Sensitivity and Specificity; D020840:Tissue Kallikreins / Q000097:blood; D014481:United States
chemical_list: D014408:Biomarkers, Tumor; D007610:Kallikreins; D020840:Tissue Kallikreins; D017430:Prostate-Specific Antigen
keywords: Kallikrein; accuracy; clinical utility; cost savings