Cost-effectiveness of Artificial Intelligence-assisted Endoscopy Screening in Countries With High Incidence of Gastric Cancer
10.3969/j.issn.1008-7125.2023.09.001
- VernacularTitle:胃癌高发病率国家人工智能内镜筛查的成本效果分析
- Author:
Xia TAN
1
,
2
,
3
,
4
;
Liwen YAO
;
Lihui ZHANG
;
Chen CHEN
;
Honggang YU
Author Information
1. 武汉大学人民医院消化内科 (430060)
2. 消化系统疾病湖北省重点实验室
3. 湖北省消化疾病微创诊治医学临床研究中心
4. 人工智能内镜介入诊疗湖北省工程研究中心
- Keywords:
Stomach Neoplasms;
Artificial Intelligence;
Endoscopy;
Screening;
Cost-Effectiveness Analysis
- From:
Chinese Journal of Gastroenterology
2023;28(9):513-522
- CountryChina
- Language:Chinese
-
Abstract:
Background:Slight mucosal lesions in the early stage of gastric cancer(GC)are difficult to recognize,and the miss rate of early GC by conventional endoscopy is high.Artificial intelligence(AI)systems can assist in the identification of gastric neoplastic lesions and reduce miss rate,but it is not clear whether AI-assisted endoscopic screening is cost-effective.Aims:The subjects of this study were to evaluate the cost-effectiveness of a population-based endoscopy screening program for GC in high-incidence countries(China,Japan and South Korea),and to explore the applicability of domestic AI--Intelligent and real-time endoscopy analytical device(IREAD)-assisted endoscopy for GC screening in these three countries.Methods:Based on the natural history of GC,a Markov model with cycle year of 1 year was constructed to compare cost-effectiveness of two strategies for GC screening in recommended age group:no screening(the control strategy),conventional endoscopy screening and IREAD-assisted endoscopy screening.Data such as transition probabilities of different states and treatment costs were obtained from previously published studies.The cost-effectiveness analysis was conducted from the perspective of society by calculating cost,Quality adjusted life years(QALY),Incremental cost effectiveness ratio(ICER).Results:The cohort results showed that 15.87%and 24.52%of GC-related deaths could be respectively avoid by conventional endoscopy screening and IREAD-assisted endoscopy screening in China,which the screening effects were similar to Japan;In South Korea,Conventional endoscopic screening and IREAD-assisted endoscopic screening averted 41.34%and 53.15%of GC-related deaths,respectively.Between the two strategies,IREAD-assisted endoscopic screening is more economic,with ICER of $34 827.61/QALY,$87 978.71/QALY and $10 574.30/QALY in China,Japan and South Korea,respectively,which were lower than the willingness-to-pay(WTP)threshold.Conclusions:When the threshold of WTP is 3 times Gross domestic product per capita,the application of AI-assisted endoscopy for GC screening in age-specific population in high-incidence countries may be more cost-effective.Meanwhile,this study provides important evidence for the promotion of domestic IRAED-assisted endoscopy in GC screening in China,Japan and South Korea.
