2024
Long-Term Outcomes of Prostate-Specific Membrane Antigen–PET Imaging of Recurrent Prostate Cancer
Kunst N, Long J, Westvold S, Sprenkle P, Kim I, Saperstein L, Rabil M, Ghaffar U, Karnes R, Ma X, Gross C, Wang S, Leapman M. Long-Term Outcomes of Prostate-Specific Membrane Antigen–PET Imaging of Recurrent Prostate Cancer. JAMA Network Open 2024, 7: e2440591. PMID: 39441595, DOI: 10.1001/jamanetworkopen.2024.40591.Peer-Reviewed Original ResearchConceptsProstate-specific antigenProstate-specific antigen levelPSMA-PETRecurrent prostate cancerBiochemical recurrenceProstate cancerLong-term outcomesProstate-specific membrane antigen positron emission tomographyEvaluation of biochemical recurrenceDetection of biochemical recurrenceLife yearsConventional imagingDefinitive local therapyPSMA PET imagingProstate cancer deathDetection of metastasesRetrospective cohort studyBase case analysisIncremental life-yearsPositron emission tomographyDecision-analytic modelLocal therapyConventional imaging strategiesDelayed treatmentDisease course
2022
Methods for Communicating the Impact of Parameter Uncertainty in a Multiple-Strategies Cost-Effectiveness Comparison
Wolff H, Qendri V, Kunst N, Alarid-Escudero F, Coupé V. Methods for Communicating the Impact of Parameter Uncertainty in a Multiple-Strategies Cost-Effectiveness Comparison. Medical Decision Making 2022, 42: 956-968. PMID: 35587181, PMCID: PMC9452448, DOI: 10.1177/0272989x221100112.Peer-Reviewed Original ResearchConceptsCost-effectiveness acceptability curvesCost-effectiveness acceptability frontierCost-effectiveness analysisImpact of uncertaintyAcceptability curvesDecision analytic modelWrong decisionsCost-effectiveness comparisonBenefit curvePolicy makersHeat mapDecision makersPotential lossIntegration of methodsDecisionsIntegration of informationDecision problemMakersOverview of methodsUncertaintyHealth policyType of informationCourse of actionRelevant informationUse toolEmerging Therapies for COVID-19: The Value of Information From More Clinical Trials
Dijk SW, Krijkamp EM, Kunst N, Gross CP, Wong JB, Hunink MGM. Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials. Value In Health 2022, 25: 1268-1280. PMID: 35490085, PMCID: PMC9045876, DOI: 10.1016/j.jval.2022.03.016.Peer-Reviewed Original ResearchConceptsCohort state-transition modelUS healthcare perspectiveValue of informationFace of uncertaintyQALY willingnessPolicy makersLifetime horizonHealthcare perspectiveState transition modelInformation analysisImmediate approvalModel outcomesImplementation decisionsOptimal momentWillingnessPolicyMakersMost valueCOVID-19DecisionsCostHorizonFurther researchAdditional evidenceUncertaintyCost‐effectiveness of second‐line therapies in adults with chronic immune thrombocytopenia
Goshua G, Sinha P, Kunst N, Pischel L, Lee AI, Cuker A. Cost‐effectiveness of second‐line therapies in adults with chronic immune thrombocytopenia. American Journal Of Hematology 2022, 98: 122-130. PMID: 35147241, PMCID: PMC9365880, DOI: 10.1002/ajh.26497.Peer-Reviewed Original ResearchConceptsThrombopoietin receptor agonistsChronic immune thrombocytopeniaSecond-line therapyImmune thrombocytopeniaEarly useCurrent practice trendsProbabilistic sensitivity analysesCost-effective treatmentFirst cost-effectiveness analysisCost-effectiveness analysisU.S. health systemLack of evidenceEarly splenectomyHematology (ASH) guidelinesReceptor agonistCurrent guidelinesSplenectomyClinical practicePractice trendsTherapyHealth systemCost-effective strategyRituximabThrombocytopeniaAmerican SocietyPopulation-Based Newborn Screening for Germline TP53 Variants: Clinical Benefits, Cost-Effectiveness, and Value of Further Research
Kunst N, Stout N, O’Brien G, Christensen K, McMahon P, Wu A, Diller L, Yeh J. Population-Based Newborn Screening for Germline TP53 Variants: Clinical Benefits, Cost-Effectiveness, and Value of Further Research. Journal Of The National Cancer Institute 2022, 114: 722-731. PMID: 35043946, PMCID: PMC9086756, DOI: 10.1093/jnci/djac013.Peer-Reviewed Original ResearchConceptsUsual careClinical benefitTP53 variantsIncremental cost-effectiveness ratioPathogenic TP53 variantsCancer-related deathGermline TP53 variantsUS birth cohortPotential health outcomesCost-effectiveness ratioIdentification of childrenTumor surveillanceClinical studiesRhabdomyosarcoma casesPediatric cancerEarly cancer detectionRoutine surveillanceBirth cohortHealth outcomesAge 20Newborn screeningMalignancy detectionFurther researchCareTP53
2021
Trends in Breast Cancer Screening Costs Among Privately Insured Women Aged 40 to 64 Years
Richman IB, Long JB, Kunst N, Kyanko K, Xu X, Busch S, Gross CP. Trends in Breast Cancer Screening Costs Among Privately Insured Women Aged 40 to 64 Years. JAMA Internal Medicine 2021, 181: 1665-1668. PMID: 34459853, PMCID: PMC8406208, DOI: 10.1001/jamainternmed.2021.4832.Peer-Reviewed Original ResearchComparative Effectiveness of Digital Breast Tomosynthesis and Mammography in Older Women
Upneja A, Long JB, Aminawung JA, Kyanko KA, Kunst N, Xu X, Busch SH, Gross CP, Richman IB. Comparative Effectiveness of Digital Breast Tomosynthesis and Mammography in Older Women. Journal Of General Internal Medicine 2021, 37: 1870-1876. PMID: 34595682, PMCID: PMC8483166, DOI: 10.1007/s11606-021-07132-6.Peer-Reviewed Original ResearchConceptsWomen 75Older womenBreast cancerAdditional cancersSubsequent imagingWomen 67Stage ITime of diagnosisEarly-stage cancerHigh rateCancer detectionConclusionsBreast cancerPrior cancerPotential confoundersScreening outcomesHealth outcomesService beneficiariesComparative effectivenessScreening mammogramsAge groupsCancerLogistic regressionResultsOur studyWomenBreast tomosynthesisSimulating Study Data to Support Expected Value of Sample Information Calculations: A Tutorial
Heath A, Strong M, Glynn D, Kunst N, Welton N, Goldhaber-Fiebert J. Simulating Study Data to Support Expected Value of Sample Information Calculations: A Tutorial. Medical Decision Making 2021, 42: 143-155. PMID: 34388954, PMCID: PMC8793320, DOI: 10.1177/0272989x211026292.Peer-Reviewed Original ResearchEarly Cost-effectiveness Analysis of Risk-Based Selection Strategies for Adjuvant Treatment in Stage II Colon Cancer: The Potential Value of Prognostic Molecular Markers
Jongeneel G, Greuter M, Kunst N, van Erning F, Koopman M, Medema J, Vermeulen L, Ijzermans J, Vink G, Punt C, Coupé V. Early Cost-effectiveness Analysis of Risk-Based Selection Strategies for Adjuvant Treatment in Stage II Colon Cancer: The Potential Value of Prognostic Molecular Markers. Cancer Epidemiology Biomarkers & Prevention 2021, 30: 1726-1734. PMID: 34162659, PMCID: PMC7611620, DOI: 10.1158/1055-9965.epi-21-0078.Peer-Reviewed Original ResearchConceptsConsensus molecular subtypesStage II colon cancerGuideline strategyEarly cost-effectiveness analysisColon cancer deathsPrognostic molecular markersMarkov cohort modelDutch societal perspectiveCancer treatment selectionCost-effectiveness analysisAdjuvant chemotherapyAdjuvant treatmentCancer deathCost-effectiveness assessmentMolecular subtypesTreatment selectionCurrent evidenceColon cancerSocietal perspectiveDecision uncertaintyMolecular markersCohort modelPatientsMarkersVOI analysisA Review of Web-Based Tools for Value-of-Information Analysis
Tuffaha H, Rothery C, Kunst N, Jackson C, Strong M, Birch S. A Review of Web-Based Tools for Value-of-Information Analysis. Applied Health Economics And Health Policy 2021, 19: 645-651. PMID: 34046866, PMCID: PMC7613968, DOI: 10.1007/s40258-021-00662-4.Peer-Reviewed Original ResearchComparative Effectiveness of Digital Breast Tomosynthesis for Breast Cancer Screening Among Women 40-64 Years Old
Richman IB, Long JB, Hoag JR, Upneja A, Hooley R, Xu X, Kunst N, Aminawung JA, Kyanko KA, Busch SH, Gross CP. Comparative Effectiveness of Digital Breast Tomosynthesis for Breast Cancer Screening Among Women 40-64 Years Old. Journal Of The National Cancer Institute 2021, 113: 1515-1522. PMID: 33822120, PMCID: PMC8757313, DOI: 10.1093/jnci/djab063.Peer-Reviewed Original ResearchConceptsHigher cancer detection rateCancer detection rateBreast cancer screeningCancer screeningScreening outcomesBreast cancer screening outcomesDigital breast tomosynthesisCancer screening outcomesPopulation-level adoptionReal-world cohortMultivariable logistic regressionHigher biopsy ratesPatient-level analysisPopulation health impactDetection rateIncident cancerClinical outcomesWomen 40Biopsy rateObservational studyComparative effectivenessLogistic regressionYoung womenPrivate health insurersWomenUnderstanding Regional Variation in the Cost of Breast Cancer Screening Among Privately Insured Women in the United States
Kunst N, Long JB, Xu X, Busch SH, Kyanko KA, Lindau ST, Richman IB, Gross CP. Understanding Regional Variation in the Cost of Breast Cancer Screening Among Privately Insured Women in the United States. Medical Care 2021, 59: 437-443. PMID: 33560712, PMCID: PMC8611614, DOI: 10.1097/mlr.0000000000001506.Peer-Reviewed Original Research
2020
Estimating Population-Based Recurrence Rates of Colorectal Cancer over Time in the United States
Kunst N, Alarid-Escudero F, Aas E, Coupé VMH, Schrag D, Kuntz KM. Estimating Population-Based Recurrence Rates of Colorectal Cancer over Time in the United States. Cancer Epidemiology Biomarkers & Prevention 2020, 29: 2710-2718. PMID: 32998946, PMCID: PMC7747688, DOI: 10.1158/1055-9965.epi-20-0490.Peer-Reviewed Original ResearchConceptsCancer recurrence rateRecurrence rateRelative survival dataColorectal cancerSurvival dataColorectal cancer-related deathsDisease-specific survival dataStage II rectal cancerStage III colorectal cancerCancer-specific death ratesStage II colon cancerPopulation-based cancer registriesColorectal cancer interventionDiagnostic time periodsMetastatic recurrence ratesRate 6 monthsNonmetastatic colorectal cancerColorectal cancer recurrenceMonths of diagnosisAnnual recurrence rateEnd Results ProgramCancer-related deathColorectal cancer diagnosisDecision analytic modelMetastatic diseaseCost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)–Positive Breast Cancer
Kunst N, Wang SY, Hood A, Mougalian SS, DiGiovanna MP, Adelson K, Pusztai L. Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)–Positive Breast Cancer. JAMA Network Open 2020, 3: e2027074. PMID: 33226431, PMCID: PMC7684449, DOI: 10.1001/jamanetworkopen.2020.27074.Peer-Reviewed Original ResearchMeSH KeywordsAdo-Trastuzumab EmtansineAdultAgedAnthracyclinesAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalAntineoplastic Agents, PhytogenicBreast NeoplasmsCase-Control StudiesCost-Benefit AnalysisCross-Linking ReagentsDrug Therapy, CombinationFemaleHumansImmunosuppressive AgentsMiddle AgedNeoadjuvant TherapyPaclitaxelQuality-Adjusted Life YearsReceptor, ErbB-2TrastuzumabTubulin ModulatorsUnited StatesConceptsErbB2-positive breast cancerAdjuvant treatment strategiesAdjuvant T-DM1Pathologic complete responseT-DM1Treatment strategiesBreast cancerKATHERINE trialResidual diseaseNeoadjuvant regimenHigher health benefitsHealth care payer perspectiveAdjuvant trastuzumab emtansineAnthracycline/cyclophosphamideDifferent adjuvant therapiesFlatiron Health databaseIncremental cost-effectiveness ratioNeoadjuvant treatment optionsHealth benefitsPositive breast cancerCare payer perspectiveCost-effectiveness ratioBase-case analysisDecision analytic modelH. PatientsBreast Cancer Screening and Health Care Costs—Reply
Kunst N, Gross CP. Breast Cancer Screening and Health Care Costs—Reply. JAMA Internal Medicine 2020, 180: 1553-1554. PMID: 32777026, DOI: 10.1001/jamainternmed.2020.2355.Peer-Reviewed Case Reports and Technical NotesPerspective and Costing in Cost-Effectiveness Analysis, 1974–2018
Kim DD, Silver MC, Kunst N, Cohen JT, Ollendorf DA, Neumann PJ. Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018. PharmacoEconomics 2020, 38: 1135-1145. PMID: 32696192, PMCID: PMC7373843, DOI: 10.1007/s40273-020-00942-2.Peer-Reviewed Original ResearchComputing the Expected Value of Sample Information Efficiently: Practical Guidance and Recommendations for Four Model-Based Methods
Kunst N, Wilson ECF, Glynn D, Alarid-Escudero F, Baio G, Brennan A, Fairley M, Goldhaber-Fiebert JD, Jackson C, Jalal H, Menzies NA, Strong M, Thom H, Heath A, Value of Information C. Computing the Expected Value of Sample Information Efficiently: Practical Guidance and Recommendations for Four Model-Based Methods. Value In Health 2020, 23: 734-742. PMID: 32540231, PMCID: PMC8183576, DOI: 10.1016/j.jval.2020.02.010.Peer-Reviewed Original ResearchUse and Costs of Breast Cancer Screening for Women in Their 40s in a US Population With Private Insurance
Kunst N, Long JB, Xu X, Busch SH, Kyanko KA, Richman IB, Gross CP. Use and Costs of Breast Cancer Screening for Women in Their 40s in a US Population With Private Insurance. JAMA Internal Medicine 2020, 180: 799-801. PMID: 32202606, PMCID: PMC7147248, DOI: 10.1001/jamainternmed.2020.0262.Peer-Reviewed Original ResearchCalculating the Expected Value of Sample Information in Practice: Considerations from 3 Case Studies
Heath A, Kunst N, Jackson C, Strong M, Alarid-Escudero F, Goldhaber-Fiebert JD, Baio G, Menzies NA, Jalal H. Calculating the Expected Value of Sample Information in Practice: Considerations from 3 Case Studies. Medical Decision Making 2020, 40: 314-326. PMID: 32297840, PMCID: PMC7968749, DOI: 10.1177/0272989x20912402.Peer-Reviewed Original ResearchConceptsHealth economic modelApproximation methodEconomic modelTraditional Monte Carlo methodTraditional Monte CarloMonte Carlo algorithmMonte Carlo methodHigh computational burdenSample informationCarlo algorithmData generation processCarlo methodMonte CarloComputational burdenComputational speedPolicy decisionsComplex decision modelsComputation methodDecision modelRealistic exampleSample sizeEVSIDifferent examplesExpected valuesCarlo
2019
A Value of Information Analysis of Research on the 21-Gene Assay for Breast Cancer Management
Kunst NR, Alarid-Escudero F, Paltiel AD, Wang SY. A Value of Information Analysis of Research on the 21-Gene Assay for Breast Cancer Management. Value In Health 2019, 22: 1102-1110. PMID: 31563252, PMCID: PMC7343670, DOI: 10.1016/j.jval.2019.05.004.Peer-Reviewed Original ResearchConceptsEarly-stage breast cancerObservational studyBreast cancerLow-risk early-stage breast cancerHormone receptor-positive early-stage breast cancerPredictive valueLow-risk womenProspective observational studyHigh-risk womenRetrospective observational studyBreast cancer managementQuality-adjusted life yearsCost-effectiveness findingsTraditional risk predictionAdjuvant chemotherapyChemotherapy useAlternative study designsOncotype DXCancer managementClinical utilityCurrent evidenceInsufficient evidenceLife yearsRoutine useStudy design