CT is cost-effective when used to screen women having LAM

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A new research, carried out at the University of Cincinnati, found that it would be cost-effective to apply CT scans for LAMscreening of non-smoking women, 25-54 years of age, who for the first time, visit the emergency room suffering from a collapsed lung, for diagnosis and treatment of lymphangioleiomyomatosis(LAM).  The research was posted online in the American Journal of Respiratory and Critical Care Medicine.

LAM is a rare, yet serious lung disease that takes place when an unusual type of cell starts to grow uncontrolled and these cells spread to several areas in the body, among them are the lungs, kidneys, and lymph nodes. Brent Kinder, MD, an investigator in the study, said "Women with LAM who first experience spontaneous lung collapse will, on average, experience two more," he added "LAM diagnosis doesn't usually occur until the second or third collapse occurs, delaying treatment. We thought that targeting screening to non-smoking women in the age range of typical LAM development may help us identify the condition earlier and improve quality of life for these patients."

Kinder and Jared Hagaman, MD, in addition to colleagues in the department of medicine, created a model to assess the cost-effectiveness of screening patients for LAM. They used national representative data sources and they revised the rates of collapsed lung and prevalence of LAM and its relation to the age, gender and smoking status of the patients. Researchers made a comparison between the benefits and the costs of applying high-resolution CT screening after lung collapse for patients with LAM to no CT screening. The costs of screenings and treatments were obtained from 2007 Medicare data.

The model was a patient, 30 years old, which comes into the emergency room suffering from lung collapse. The patient is a non-smoking female with 5% positive LAM.  Dr. Kinder said "Screening for LAM using a CT, or three-dimensional X-ray of the lungs, is the most cost-effective strategy, with approximately $32,000 per quality-adjusted life year gained. For comparison, hemodialysis, a standard benchmark for cost-effectiveness, costs about $50,000 per quality-adjusted life year gained," he added "We believe the benefits of testing outweigh any negative impact on patients with LAM. The radiation dose of a high-resolution CT scan is approximately one-tenth of conventional CT scans, and with newer technology, the radiation exposure continues to decrease." and "This data will help physicians intervene with therapies more quickly and enroll patients in clinical trials that may be able to slow progression of the disease."

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