UNASSIGNED: Empirical antifungal therapy is frequently used in hematology @entity1 at high risk of @entity3 ( @entity3 ), with substantial cost and @entity137 . Biomarkers for @entity3 aim for earlier and more accurate diagnosis and targeted treatment. However, data on the cost-effectiveness of a biomarker-based diagnostic strategy (BDS) are limited. We evaluated the cost effectiveness of BDS using results from a randomized controlled trial (RCT) and individual @entity1 costing data. Data inputs derived from a published RCT were used to construct a decision-analytic model to compare BDS (Aspergillus galactomannan and PCR on blood) with @entity3129 ( @entity3129 ) of culture and histology in terms of total costs, length of stay, @entity3 incidence, mortality, and years of life saved. Costs were estimated for each @entity1 using hospital costing data to day 180 and follow-up for survival was modeled to five years using a Gompertz survival model. Treatment costs were determined for 137 adults undergoing allogeneic hematopoietic stem cell transplant or receiving chemotherapy for acute @entity1778 in four Australian centers (2005-2009). Median total costs at 180 days were similar between groups (US[Formula: see text] for @entity3129 [IQR US[Formula: see text]] and US[Formula: see text] for BDS [IQR US[Formula: see text]], P = .49). All-cause mortality was 14.7% (10/68) for @entity3129 and 10.1% (7/69) for BDS, (P = .573). The costs per life-year saved were US[Formula: see text], and US[Formula: see text] at 180 days, one year and five years, respectively. BDS is not cost-sparing but is cost-effective if a survival benefit is maintained over several years. An individualized institutional approach to diagnostic strategies may maximize utility and cost-effectiveness.

Is a biomarker-based diagnostic strategy for XXXX cost effective in high-risk haematology @entity1 ?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity3129 :: ('MESH:D005119', 'Disease') :: ['standard diagnostic strategy', 'SDS'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity1778 :: ('MESH:D007938', 'Disease') :: ['leukemia'] @entity3 :: ('MESH:D009362', 'Disease') :: ['invasive aspergillosis', 'IA']
@entity3 :: (MESH:D009362,Disease) :: ['invasive aspergillosis']
