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Table 4 Modelling results for a hypothetical cohort of 1000 patients referred for elevated PSA using different strategies for cancer detection. In brackets are projected reductions compared to the base model (* compared to MRI + biopsy all)

From: Clinical utility and cost modelling of the phi test to triage referrals into image-based diagnostic services for suspected prostate cancer: the PRIM (Phi to RefIne Mri) study

 Pathway
MRI + biopsy allMRI all + biopsy if M3–5MRI all + biopsy if M3–5 or PSAd ≥ 0.15MRI all + biopsy if M3–5 or PSAd ≥ 0.10MRI + biopsy only ifphi ≥ 25MRI + biopsy only ifphi ≥ 30
No. of MRI scans (% lower*)10001000 (0%)1000 (0%)1000 (0%)850 (−15%)750 (−25%)
No. of biopsies needed (% lower*)1000772 (−23%)884 (−12%)941 (−6%)850 (−15%)750 (−25%)
Detection of ≥ GG2 cancers
 Cancers identified (% lower*)100%91% (−9%)98% (−2%)99% (−1%)96% (−4%)92% (−8%)
 Unnecessary biopsies (% lower*)527343 (−35%)420 (−20%)471 (−11%)396 (−25%)314 (−40%)
Detection of ≥ CPG3 cancers
 Cancers identified (% lower*)100%95% (−5%)100% (0%)100% (0%)99% (−1%)95% (−5%)
 Unnecessary biopsies (% lower*)677466 (−31%)562 (−17%)618 (−9%)529 (−21%)442 (−35%)
Cost analysis
 Cost/pt. (% lower*)£965£796 (−18%)£879 (−9%)£921 (−5%)£869 (−10%)£774 (−20%)