BACKGROUND: Many Western countries have long-established population-based mammography screening programs. Prior to implementing these programs, decision-analytic modeling was widely used to inform decisions. OBJECTIVE: The aim of this study was to perform a systematic review of cost-effectiveness models in @entity0 screening in the general population to analyze their structural and methodological approaches. METHODS: A systematic literature search for health economic models was performed in the electronic databases MEDLINE (Ovid), EMBASE, @entity1509 Databases, Cochrane Library, and EconLit in August 2011 with updates in June 2013, April 2015, and November 2016. To assess studies systematically, a standardized form was applied to extract relevant information that was then summarized in evidence tables. RESULTS: Thirty-five studies were included; 27 state-transition models were analyzed using cohort (n  =  12) and individual-level simulation (n  =  15). Twenty-one studies modeled the natural history of @entity0 and predicted mortality as a function of the early detection modality. The models employed different assumptions regarding @entity513 in situ. Thirteen studies performed cost-utility analyses with different sources for utility values, but assumptions were often made about utility weights. Twenty-two models did not report any validation. CONCLUSION: State-transition modeling was the most frequently applied analytic approach. Different methods in modeling the progression of @entity513 in situ to invasive @entity5 were identified because there is currently no agreement on the biological behavior of noninvasive @entity0 . Main weaknesses were the lack of precise utility estimates and insufficient reporting of validation. Sensitivity analyses of assumptions regarding @entity513 in situ and in particular adequate validation are critical to minimize the risk of biased model outcomes.

Cost-Effectiveness Models in XXXX Screening in the General Population: A Systematic Review.

@entity513 :: ('MESH:D044584', 'Disease') :: ['ductal carcinoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity1509 :: ('OMIM:120970', 'Disease') :: ['CRD']
@entity0 :: (MESH:D001943,Disease) :: ['Breast Cancer']
