The changing costs of radiation treatment for early prostate cancer in Ontario: a comparison between conventional and conformal external beam radiotherapy.
Notice bibliographique
Résumé
PURPOSE: Prostate cancer represents a large part of the workload for radiation oncology departments in Canada. Recent evidence suggests that conformal external beam radiotherapy improves results. The planning and treatment process for conformal patients requires a greater amount of resources that are in short supply in Ontario. An understanding of these differences is important to provide an accurate estimate of future radiation needs of the province. These differences can be quantified in a cost model that portrays the direct costs of delivering external beam radiotherapy in Ontario. With a developed cost model, a prospective direct cost comparison between standard four field external beam radiotherapy versus conformal radiotherapy in early stage prostate carcinoma was designed. METHODS: Activity based costing has been used to create a model of radiotherapy related costs for prostate cancer. A process map was developed which separated the process in five activities for conventional radiotherapy and six activities for dose escalated conformal radiotherapy. Time was recognized as the important cost driver within each activity. The time required for pre-treatment preparation (CT planning, dosimetry, simulation, and other preparatory work) and actual treatment times were collected prospectively. Treatment times were collected in 414 patients. The annual costs of capital equipment purchase costs and specialized construction of hospital space for radiotherapy equipment were amortized using a 6% discount rate plus the cost of annual maintenance. Indirect costs were not included in this cost analysis. RESULTS: An activity based costing model using time as the primary cost driver reflects the additional costs of conformal over conventional external beam radiotherapy. The costs of single phase and double phase six field conformal therapy with 42 fractions delivered was 7867 Canadian dollars and 8227 Canadian dollars per patient. Four field single phase conformal therapy with 28 fractions costs 5723 Canadian dollars. The cost of conventional radiotherapy over 33 fractions was 3068 Canadian dollars. The majority of the cost differences arose from the cost of the additional time needed for treatment per day as well as the extra fractions per patient when compared to conventionally treated patients. The average treatment times per fraction for six field conformal, four field conformal and four field conventional have the median times of 22.72, 20.63 and 11.07 minutes respectively. Planning costs for conformal radiotherapy were up to three times the cost of conventional therapy. CONCLUSIONS: The direct costs of dose escalated conformal external beam radiotherapy are over 2.5 times that of conventional external beam radiotherapy for early stage prostate cancer. These direct costs are a reflection of the additional capital and human resources needed to provide state-of-the-art radiation therapy in the province of Ontario. Planning for radiation oncology needs should consider the additional costs of conformal external beam radiotherapy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».