Expert Elicitation to Inform a Cost-Effectiveness Analysis of Screening for Renal Cancer

Area of Science:

• Oncology
• Health Economics
• Medical Imaging

Background:

• Population screening for renal cell carcinoma (RCC) using ultrasound shows promise for improving survival.
• A cost-effectiveness analysis (CEA) for RCC screening is lacking due to insufficient data.
• Structured expert elicitation was employed to gather necessary data for a CEA.

Purpose of the Study:

• To elicit cancer stage distributions for various RCC screening scenarios.
• To determine annual transition probabilities for undiagnosed RCC to diagnosed cases within the NHS.
• To provide essential parameters for a future CEA of RCC screening.

Main Methods:

• Adherence to Reporting Guidelines for the Use of Expert Judgement in Model-Based Economic Evaluations.
• Face-to-face or telephone-based expert elicitation sessions.
• Application of Connor-Mosimann and modified Connor-Mosimann distributions for data analysis.

Main Results:

• 71% participation from 24 invited clinical experts (urologists, oncologists, radiologists).
• Modified Connor-Mosimann distribution demonstrated the best fit for most elicited data.
• Higher uncertainty observed in elicited transition probabilities compared to stage distributions.

Conclusions:

• This study represents the first expert elicitation of RCC screening parameters.
• The gathered data are crucial for informing the CEA of RCC screening.
• Elicited quantities can facilitate future health economic evaluations of RCC diagnostic tools and pathways.