Instituto de Doenças do Torax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil.
PLoS One. 2020 Jun 30;15(6):e0235479. doi: 10.1371/journal.pone.0235479. eCollection 2020.
The emergence of endobronchial ultrasound (EBUS) changed the approach to staging lung cancer. As a new method being incorporated, the use of EBUS may lead to a shift in clinical and costs outcomes.
The aim of this systematic review is to gather information to better understand the economic impact of implementing EBUS.
This review is reported according to the PRISMA statement and registered on PROSPERO (CRD42019107901). Search keywords were elaborated considering descriptors of terms related to the disease (lung cancer / mediastinal staging of lung cancer) and the technologies of interest (EBUS and mediastinoscopy) combined with a specific economic filter. The literature search was performed in MEDLINE, EMBASE, LILACS, Cochrane Library of Trials, Web of Science, Scopus and National Health System Economic Evaluation Database (NHS EED) of the Center for Reviews and Dissemination (CRD). Screening, selection of articles, data extraction and quality assessment were carried out by two reviewers.
Seven hundred and seventy publications were identified through the database searches. Eight articles were included in this review. All publications are full economic evaluation studies, one cost-effectiveness, three cost-utility, and four cost-minimization analyses. The costs of strategies using EBUS-TBNA were lower than the ones using mediastinoscopy in all studies analyzed. Two of the best quality scored studies demonstrate that the mediastinoscopy strategy is dominated by the EBUS-TBNA strategy.
Information gathered in the eight studies of this systematic review suggest that EBUS is cost-effective compared to mediastinoscopy for mediastinal staging of lung cancer.
支气管内超声（EBUS）的出现改变了肺癌分期的方法。作为一种新纳入的方法，EBUS 的使用可能会导致临床和成本结果的转变。
本系统评价的目的是收集信息，以更好地了解实施 EBUS 的经济影响。
本综述按照 PRISMA 声明进行报告，并在 PROSPERO（CRD42019107901）上进行了注册。搜索关键词是根据与疾病相关的术语（肺癌/肺癌纵隔分期）和感兴趣的技术（EBUS 和纵隔镜检查）的描述符以及特定的经济筛选器进行精心制定的。文献检索在 MEDLINE、EMBASE、LILACS、Cochrane 临床试验图书馆、Web of Science、Scopus 和中心审查和传播（CRD）的国家卫生系统经济评估数据库（NHS EED）中进行。筛选、文章选择、数据提取和质量评估由两名评审员进行。
通过数据库搜索共确定了 770 篇出版物。本综述共纳入 8 篇文章。所有出版物均为全经济评价研究，1 篇为成本效益分析，3 篇为成本效用分析，4 篇为成本最小化分析。在所有分析的研究中，使用 EBUS-TBNA 的策略的成本均低于使用纵隔镜检查的策略。两项质量评分最高的研究表明，纵隔镜检查策略被 EBUS-TBNA 策略所主导。
本系统评价中纳入的 8 项研究提供的信息表明，与纵隔镜检查相比，EBUS 对肺癌纵隔分期具有成本效益。
