title: Cost-effectiveness analysis in melanoma detection: A transition model applied to dermoscopy.
abstract: The main aim of this study is to demonstrate how our melanoma disease model (MDM) can be used for cost-effectiveness analyses (CEAs) in the melanoma detection field. In particular, we used the data of two cohorts of Belgian melanoma patients to investigate the cost-effectiveness of dermoscopy.
  
  
  
  A MDM, previously constructed to calculate the melanoma burden, was slightly modified to be suitable for CEAs. Two cohorts of patients entered into the model to calculate morbidity, mortality and costs. These cohorts were constituted by melanoma patients diagnosed by dermatologists adequately, or not adequately, trained in dermoscopy. Effectiveness and costs were calculated for each cohort and compared. Effectiveness was expressed in quality-adjusted life years (QALYs), a composite measure depending on melanoma-related morbidity and mortality. Costs included costs of treatment and follow-up as well as costs of detection in non-melanoma patients and costs of excision and pathology of benign lesions excised to rule out melanoma.
  
  
  
  The result of our analysis concluded that melanoma diagnosis by dermatologists adequately trained in dermoscopy resulted in both a gain of QALYs (less morbidity and/or mortality) and a reduction in costs.
  
  
  
  This study demonstrates how our MDM can be used in CEAs in the melanoma detection field. The model and the methodology suggested in this paper were applied to two cohorts of Belgian melanoma patients. Their analysis concluded that adequate dermoscopy training is cost-effective. The results should be confirmed by a large-scale randomised study.
authors: Department of Dermatology, Institut Roi Albert II, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium. Electronic address: Isabelle.tromme@uclouvain.be.
authors: Isabelle
authors: I
authors: Tromme
authors: Institute of Statistics, Biostatistics and Actuarial Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
authors: Catherine
authors: C
authors: Legrand
authors: Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors: Brecht
authors: B
authors: Devleesschauwer
authors: Department of Dermatology, Eberhard Karls University, Tübingen, Germany.
authors: Ulrike
authors: U
authors: Leiter
authors: European Organization for Research and Treatment of Cancer, Brussels, Belgium.
authors: Stefan
authors: S
authors: Suciu
authors: Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.
authors: Alexander
authors: A
authors: Eggermont
authors: Department of Dermatology, Institut Roi Albert II, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium.
authors: Laurine
authors: L
authors: Sacré
authors: Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium.
authors: Jean-François
authors: JF
authors: Baurain
authors: Department of Dermatology, Centre Hospitalier Lyon Sud, Lyon 1 University, Lyons Cancer Research Center, France.
authors: Luc
authors: L
authors: Thomas
authors: Centre for Health Economics Research & Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine & Health Sciences, University of Antwerp, Belgium.
authors: Philippe
authors: P
authors: Beutels
authors: Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.
authors: Niko
authors: N
authors: Speybroeck
mesh_terms: D001530:Belgium; D003362:Cost-Benefit Analysis; D003880:Dermatology / Q000193:education; D046169:Dermoscopy / Q000191:economics / Q000193:education / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000191:economics / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000473:pathology / Q000628:therapy
keywords: Cost-effectiveness analysis; Dermoscopy; Melanoma