title: A review of economic evaluations of diagnostic strategies using imaging in men at risk of prostate cancer.
abstract: OBJECTIVE
  The role of imaging, particularly MRI, in diagnosing clinically significant prostate cancer is the focus of a rapidly developing body of clinical research. We identified five economic evaluations of multiparametric magnetic resonance imaging (mpMRI) for diagnosing prostate cancer which report very different results. This review aims to explain why the reported cost-effectiveness of mpMRI varies so widely.
  
  
  RESULTS
  The studies evaluate the cost-effectiveness of mpMRI within different clinical pathways; before biopsy and after a negative biopsy. Although there were important differences in the questions posed, the studies also employed different assumptions about the impact of prostate cancer and its treatment on survival and quality of life.
  
  
  CONCLUSIONS
  This review highlights the need for a better standard of reporting around key modelling assumptions. Also, a wider range of sensitivity analyses should explore the impact of these structural assumptions on the model results, in addition to the more commonly acknowledged uncertainty around data inputs for the model parameters.
authors.affiliation: aDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine bDivision of Surgery and Interventional Science, University College London cDepartment of Urology, University College Hospitals NHS Foundation Trust, London, UK dDepartment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Willis
authors.forename: Jan
authors.initials: J
authors.lastname: van der Meulen
authors.forename: Massimo
authors.initials: M
authors.lastname: Valerio
authors.forename: Alec
authors.initials: A
authors.lastname: Miners
authors.forename: Hashim U
authors.initials: HU
authors.lastname: Ahmed
authors.forename: Mark
authors.initials: M
authors.lastname: Emberton
mesh_terms: D001706:Biopsy / Q000191:economics; D003362:Cost-Benefit Analysis; D019091:Critical Pathways; D003661:Decision Support Techniques; D003663:Decision Trees; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods; D017048:Health Care Costs; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics*; D008297:Male; D054526:Men's Health / Q000191:economics*; D011237:Predictive Value of Tests; D011471:Prostatic Neoplasms / Q000191:economics* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome