虽然之前的研究已经评估了特定技术的临床或经济价值，但提高各种技术对肺癌诊断的恶性肿瘤敏感性的经济价值尚不清楚。 确定提高支气管镜活检对肺癌诊断的敏感性的经济价值。开发了决策分析模型来量化外周肺部病变支气管镜活检中恶性肿瘤敏感性增加的经济价值。主要临床结果包括诊断时间和生存率。经济成果包括 (i) 净货币效益 (NMB)，定义为以质量调整生命年 (QALY) 乘以支付意愿 (100,000 美元/QALY) 扣除医疗费用变化后衡量的健康效益，以及 (ii) 增量成本-有效性比（ICER）。开发了具有两个马尔可夫模块分支的决策树建模框架。两个马尔可夫模块对应于（i）诊断并治疗或（ii）未诊断且未治疗的癌症患者。结果是从美国付款人的角度衡量了 30 年来的结果。将恶性肿瘤的敏感性提高 10 个百分点，可将肺癌患者的平均诊断时间缩短 0.85 个月（4 周），并将生存期延长 0.36 年（19 周），因为更快地开始治疗。每位患者的总体健康结果改善了 0.20 QALY。每位患者的费用增加了 6,727 美元，主要是由于诊断为癌症的患者的治疗费用增加。对恶性肿瘤的敏感性提高 10 个百分点，30 年来 NMB 增加了 8,729 美元（ICER 为 34,052 美元），这主要是由于对早期癌症的敏感性提高（特定阶段 NMB：I/II：19,805 美元；III：2,101 美元；IV：- 1,438 美元）。总 NMB 的 42%（3,668 美元）是在活检后 5 年内产生的。敏感性变化与 NMB 之间的关系近似线性（1% 与 10% 敏感性改善对应的 NMB 为 885 美元与 8,729 美元）。该模型对癌症治疗效果和阴性结果后的随访时间最为敏感。恶性肿瘤敏感性提高 10 个百分点，净经济价值将提高 8,729 美元。卫生系统在做出有关新支气管镜技术价值的决策时可以使用这些信息。本文是开放获取的，并根据知识共享署名非商业性无衍生许可证 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/) 的条款进行分发。

While previous studies have assessed the clinical or economic value of specific technologies, the economic value of improving sensitivity for malignancy for lung cancer diagnoses broadly across technologies is unclear.To identify the economic value of improving sensitivity of bronchoscopy biopsy for the diagnosis of lung cancer.A decision analytic model was developed to quantify the economic value of increased sensitivity for malignancy for bronchoscopy biopsy of peripheral pulmonary lesions. Primary clinical outcomes included time-to-diagnosis and survival. Economic outcomes included (i) net monetary benefit (NMB), defined as the health benefits measured in quality-adjusted life year (QALY) times willingness to pay ($100,000/QALY) net of changes in medical costs, and (ii) incremental cost-effectiveness ratio (ICER). A decision tree modeling framework-with two Markov module branches-was developed. The two Markov modules corresponded to cancer patients who were (i) diagnosed and treated or (ii) undiagnosed and remained untreated. Outcomes were measured from a US payer perspective over 30 years.Improving sensitivity for malignancy by 10 percentage points decreased average time-to-diagnosis for lung cancer patients by 0.85 months (4 weeks) and increased survival by 0.36 years (19 weeks), due to faster treatment initiation. Overall health outcomes improved by 0.20 QALYs per patient. Cost increased by $6,727 per patient primarily through increased treatment costs among those diagnosed with cancer. Increasing sensitivity for malignancy by 10 percentage points improved NMB by $8,729 over 30 years (ICER of $34,052), driven largely by improved sensitivity to early-stage cancer (stage-specific NMB: I/II: $19,805; III: $2,101; IV: -$1,438). Forty-two percent of overall NMB ($3,668) accrued within 5 years of biopsy. The relationship between change in sensitivity and NMB was approximately linear (1% vs. 10% sensitivity improvement corresponded to NMB of $885 vs $8,729). The model was most sensitive to cancer treatment efficacy and follow-up time after a negative result.Increasing sensitivity of malignancy by 10 percentage points resulted in a $8,729 improvement in net economic value. Health systems can use this information when making decisions regarding the value of new bronchoscopy technologies. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ).