Anupam Tyagi PhD and Jill Morris PhD
Tables
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TABLE 1: Outcome and cost measures that may be included in an assessment of family history tools
Behavior or behavioral risk factors changed
Nonbehavioral risk factors changed
Change in risk from change in risk factors
Time saved to detection of risk factors (early detection)
Time saved to detection of onset of conditions
Mortality averted
Disease cases averted
Life-years saved
Quality- and disability-adjusted life years saved (QALYs and
DALYs)
Productivity loss avoided
Money saved by (1) individual, (2) family members, (3) provider or insurer, (4) public health agencies, and (5) society |
Time cost to patient
Cost of collecting information
Cost of managing information
Cost of communicating the information to patients, e.g., counseling
Cost of clinically using the information (computer-assisted decision making may be helpful)
Screening and testing costs for individual (including
adverse social, psychological, and health outcomes)
Screening and testing costs for the family members for
risk factors, if necessary
Cost of screening program
Cost of treatment or behavior change |
TABLE 2: Assumptions used to assess utility of a hypothetical
family history (FH) tool for colorectal cancer (CRC)
| Prevalence of CRC FH |
Not requireda |
13% (moderate FH) |
| |
|
2% (strong FH) |
| Proportion of
individuals
screened |
20% |
100% (strong FH) |
| |
|
100% (moderate FH) |
| |
|
20% (no FH) |
| CRC lifetime risk |
4.6% |
20% (strong FH) |
| |
|
6% (moderate FH) |
| |
|
4% (no FH) |
| Reduction in risk
from screening |
50% reduction |
50% reduction |
TABLE 3: Results of the illustrative decision analysis
| No screeningb |
4580 |
N/A |
N/A |
| Current practice |
4122 |
458 |
N/A |
| Family history (FH) stratification, assuming 100% of
persons with strong FH are screenedcd |
3962 |
618 |
160 |
| FH stratification, assuming 100% of persons with strong
and moderate FHs are screenede |
3650 |
930 |
472 |
| 100% population-wide screeningb |
2290 |
2290 |
1832 |
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