Skip Navigation
Menu
Editorials |20 May 2014

Cost-Effectiveness of Screening for Asymptomatic Left Ventricular Dysfunction in Childhood Cancer Survivors

Richard M. Steingart, MD; Jennifer E. Liu, MD; Kevin C. Oeffinger, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From Memorial Sloan Kettering Cancer Center and Weill Medical College of Cornell University, New York, New York.

    Acknowledgment: The authors thank Jersey Chen, MD, from the Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, for his thoughtful comments on cost-effectiveness analyses.

    Disclosures: None. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0823.

    Requests for Single Reprints: Richard M. Steingart, MD, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065; e-mail, steingar@mskcc.org.

    Current Author Addresses: Drs. Steingart and Liu: Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065.

    Dr. Oeffinger: Memorial Sloan Kettering Breast and Imaging Center, 300 East 66th Street, New York, NY 10065.

×
FULL TEXT
It has long been recognized that anthracycline chemotherapy can cause early- and late-onset congestive heart failure (CHF) and cardiomyopathy, which may progress to cardiac-specific death (1). Thus, children treated with anthracycline are monitored during and periodically after therapy. The Children's Oncology Group (COG) developed the Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers (COG-LTFU) in 2003 (2). In brief, periodic lifetime screening is recommended, based on age at treatment, cumulative anthracycline dose, and whether the heart was irradiated. These recommendations have been widely adopted.
In this issue, 2 groups separately examined these recommendations and report on the cost-effectiveness (CE) of screening to detect asymptomatic left ventricular dysfunction (ALVD) and to reduce CHF risks in childhood cancer survivors who were exposed to anthracycline chemotherapy (3, 4).
Cost-effectiveness analysis is a method for evaluating health outcomes and resource costs for health interventions. A base case is established that incorporates data and methods that best represent the interventions and choices under consideration. Its central function is to show the relative value of alternative interventions for improving health. In this case, it represents “no screening” for ALVD in childhood cancer survivors versus the recommendations of the COG-LTFU guidelines, then varies the screening interval and other variables to determine the CE of different strategies (5). Such analysis should be used as a supplement to other considerations in health care delivery, including equity, “benefits many,” and community compassion. The perspective used in the CE analysis is of overarching...
FULL TEXT
PDF
Not Available
Citations
Citation

Steingart RM, Liu JE, Oeffinger KC. Cost-Effectiveness of Screening for Asymptomatic Left Ventricular Dysfunction in Childhood Cancer Survivors. Ann Intern Med. 2014;160:731–732. doi: 10.7326/M14-0823

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 2014;160(10):731-732.

DOI: 10.7326/M14-0823

5 Citations

Related Articles
Routine Echocardiography Screening for Asymptomatic Left Ventricular Dysfunction in Childhood Cancer Survivors: A Model-Based Estimation of the Clinical and Economic Effects
Annals of Internal Medicine; 160 (10): 661-671
Cost-Effectiveness of the Children's Oncology Group Long-Term Follow-up Screening Guidelines for Childhood Cancer Survivors at Risk for Treatment-Related Heart Failure
Annals of Internal Medicine; 160 (10): 672-683
Triple Therapy Versus Biologic Therapy for Active Rheumatoid Arthritis: A Cost-Effectiveness Analysis
Annals of Internal Medicine; 167 (1): 8-16
General Internists’ Preferences and Knowledge About the Care of Adult Survivors of Childhood Cancer: A Cross-sectional Survey
Annals of Internal Medicine; 160 (1): 11-17
View MoreView Less

Journal Club
Review: Newer second-line drugs for diabetes are not more cost-effective than sulfonylureas
Annals of Internal Medicine; 168 (2): JC8
In CAD with LV dysfunction, adding CABG to medical therapy reduced all-cause and CV mortality at 10 y
Annals of Internal Medicine; 165 (4): JC15
In treatment-resistant depression, adding cognitive–behavioral therapy to usual care was cost-effective at 1 y
Annals of Internal Medicine; 160 (12): JC13
Review: Approved and some off-label preventive drugs reduce migraine frequency in episodic migraine
Annals of Internal Medicine; 159 (8): JC11
View MoreView Less

Related Point of Care
Care of the Adult Cancer Survivor
Annals of Internal Medicine; 158 (11): ITC6-1
View MoreView Less

Related Topics
Cancer Survivorship
Cardiac Diagnosis and Imaging
Cardiology
Healthcare Delivery and Policy
Hematology/Oncology

Cancer Survivorship, Cardiac Diagnosis and Imaging, Cardiology, Healthcare Delivery and Policy, Hematology/Oncology.

PubMed Articles
Revascularization in left ventricular dysfunction: an update.
Curr Opin Cardiol 2019;34(5):536-542.
Assessment of myocardial viability by cardiac MRI.
Curr Opin Cardiol 2019;34(5):502-509.
View More

Results provided by: PubMed

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×