Cost-effectiveness of CT T1N0M0 lung cancer

The role of CT in the evaluation of clinically staged T1N0M0 lung cancer is controversial. Using the methods of decision analysis, the authors show how the utility and cost-effectiveness of CT are dependent on several variables: the prevalence of mediastinal metastases in T1N0M0 patients; the sensitivity and specificity of CT; life expectancy; and the mortalities and dollar costs of cT, surgical staging procedures, and curative thoracotomy. Furthermore, they demonstrate that a true positive yield of 7% is sufficient for chest CT to be both clinically useful and cost-saving