RT Journal Article SR Electronic T1 Health economic evaluation of a serum-based blood test for brain tumour diagnosis: exploration of two clinical scenarios JF BMJ Open JO BMJ Open FD British Medical Journal Publishing Group SP e017593 DO 10.1136/bmjopen-2017-017593 VO 8 IS 5 A1 Ewan Gray A1 Holly J Butler A1 Ruth Board A1 Paul M Brennan A1 Anthony J Chalmers A1 Timothy Dawson A1 John Goodden A1 Willie Hamilton A1 Mark G Hegarty A1 Allan James A1 Michael D Jenkinson A1 David Kernick A1 Elvira Lekka A1 Laurent J Livermore A1 Samantha J Mills A1 Kevin O’Neill A1 David S Palmer A1 Babar Vaqas A1 Matthew J Baker YR 2018 UL http://bmjopen.bmj.com/content/8/5/e017593.abstract AB Objectives To determine the potential costs and health benefits of a serum-based spectroscopic triage tool for brain tumours, which could be developed to reduce diagnostic delays in the current clinical pathway.Design A model-based health pre-trial economic assessment. Decision tree models were constructed based on simplified diagnostic pathways. Models were populated with parameters identified from rapid reviews of the literature and clinical expert opinion.Setting Explored as a test in both primary and secondary care (neuroimaging) in the UK health service, as well as application to the USA.Participants Calculations based on an initial cohort of 10 000 patients. In primary care, it is estimated that the volume of tests would approach 75 000 per annum. The volume of tests in secondary care is estimated at 53 000 per annum.Main outcome measures The primary outcome measure was quality-adjusted life-years (QALY), which were employed to derive incremental cost-effectiveness ratios (ICER) in a cost-effectiveness analysis.Results Results indicate that using a blood-based spectroscopic test in both scenarios has the potential to be highly cost-effective in a health technology assessment agency decision-making process, as ICERs were well below standard threshold values of £20 000–£30 000 per QALY. This test may be cost-effective in both scenarios with test sensitivities and specificities as low as 80%; however, the price of the test would need to be lower (less than approximately £40).Conclusion Use of this test as triage tool in primary care has the potential to be both more effective and cost saving for the health service. In secondary care, this test would also be deemed more effective than the current diagnostic pathway.