Table 1.

Model inputs and ranges for sensitivity analysis

VariableBase caseSensitivity analysis rangeReference(s)
Polyposis distribution and progression
    Stage distribution at age 30 (%)See Methods
        Stage 080100/60
        Stage I110/18
        Stage II90/10
        Stage III00/10
        Stage IV00/2
        Cancer00/0
    Transition probabilities per month (%)
        Stages 0 to IV0.4650-200% × BCSee Methods
        Stage IV to cancer0.3750-200% × BC
Endoscopy characteristics
    Screening frequency(16, 17)
        Stage 05 y
        Stage I5 y
        Stage II3 y
        Stage III1 y
        Stage IV6 mo
    Complication rate1.6:100,00050-200% × BC(27, 28)
    False-negative rate (%)290-60(26)
    Symptomatic cancer presentation (%)500-100(23, 29)
PD characteristics
    Eligible for curative surgery (%), age25-75(30)
        30-3950
        40-4966
        50-5964
        60-6960
        70-7955
        80+33
    Perioperative mortality (%)50-10(32, 33)
Cancer mortality per month
    Age related1.6 × U.S. life table1-2.1 × U.S. life table(12, 35)
    Undiagnosed cancer (%)0.110-1,000% × BC(30)
    Post-curative surgery (%), mo50-200% × BC(34)
        0-71.8
        8-410.89
        42-860.41
        87+0
    Post-palliative surgery (%), mo50-200% × BC(34)
        0-1212
        13+5.7
Outcome adjustments
    Utility reductions
        Endoscopy-0.3 * 1 d0-0.5(47)
        Endoscopy complication-0.3 * 1 wk0-0.5(47)
        PD-0.3 * 4 wk0-0.5(40)
    Quality of life adjustment factors
        Well, age1(48)
            30-390.91
            40-490.88
            50-590.85
            60-690.83
            70-790.79
            80+0.75
        Post-PD0.980.8-1See Methods
        Cancer0.470.25-1(49, 50)
    Discount rate (%)30-5(51)
Costs ($)
    Cancer care67,56550-200% × BC(52)
    Endoscopy90350-200% × BC(53)
    Endoscopy complication9,35550-200% × BC(54)
    PD30,56850-200% × BC(40)
    Post-PD15950-200% × BCSee Methods
    Day's wages14750-200% × BCU.S. Bureau of Labor

Abbreviations: BC, base-case scenario; PD, pancreaticoduodenectomy.