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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 all

MRI all + biopsy if M3–5

MRI all + biopsy if M3–5 or PSAd ≥ 0.15

MRI all + biopsy if M3–5 or PSAd ≥ 0.10

MRI + biopsy only ifphi ≥ 25

MRI + biopsy only ifphi ≥ 30

No. of MRI scans (% lower*)

1000

1000 (0%)

1000 (0%)

1000 (0%)

850 (−15%)

750 (−25%)

No. of biopsies needed (% lower*)

1000

772 (−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*)

527

343 (−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*)

677

466 (−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%)