Cost effectiveness modelling in uveal melanoma using LUMPO
Research type
Research Study
Full title
Cost effectiveness modelling for adaptive liver surveillance in uveal melanoma patients screened with Magnetic Resonance Image or Ultrasound using the Liverpool Uveal Melanoma Prognosticator Online (LUMPO).
IRAS ID
247503
Contact name
SE Coupland
Contact email
Sponsor organisation
University of Liverpool
Duration of Study in the UK
2 years, 10 months, 26 days
Research summary
Summary of Research
The project aims to determine the cost-effectiveness and sensitivity of a mathematical model (LUMPO) that estimates prognosis and screening intervals for patients with uveal melanoma. By undertaking a retrospective analysis of the predictions made by LUMPO compared with the actual screening and outcome data for the same individuals, the effectiveness and sensitivity of LUMPO to improve quality of life by reducing the number of unnecessary scans can be determined.Summary of Results
Despite being associated with a high metastatic risk, there is no consensus in the ophthalmology or oncology community on the role of liver surveillance for the detection of metastatic disease in patients with uveal melanoma, a rare eye cancer. The lack of consensus is due to the absence of clear data on the best surveillance modality, surveillance frequency or duration. The value of routine surveillance or for some clinicians to completely abandon surveillance has been controversial. Currently, in Liverpool we use a mathematical model to predict the risk for individual patients that their cancer will spread to other sites outside the eye, most commonly the liver. This tool is called LUMPO3 and has been developed from analysis of large amounts of clinical data. The study undertaken had two aims:AIM 1 - To determine the cost effectiveness and sensitivity of LUMPO to predict liver screening intervals in patients with uveal melanoma.
By undertaking a retrospective analysis of the predictions made by LUMPO compared with the actual screening and outcome data for the same individuals, the ability of LUMPO to improve quality of life by reducing the number of unnecessary scans was determined.
Results of this study are published in https://eur03.safelinks.protection.outlook.com/?url=http%3A%2F%2Furl6570.hra.nhs.uk%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbQne05VVe0UaW9iiRd6kqFpRiQwQLugcEJaYhMzh99pQPE5XHoKpZ5neYx4j1Hg9Fw-3D-3DZ5Yl_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YIu2IRSBEv2lZ2NCC5yzxlwqOzH1mXQWH9GK3ED7osB01XscrSRVcw49vMnABTMlIm5NciWm-2BRV87ubsbR9oiJxd7hQusDlpRYp-2FIJeHBCL1LLPnR4lr4LTZFWqScBbNWj5FsBJPuEkRJMo7H43-2BJbWvoNSZ34VFNbtlzdUrTOZrQ-3D-3D&data=04%7C01%7Capprovals%40hra.nhs.uk%7Cc52c11fd25024e67915508da13fda416%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637844277341655518%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=DWKmGFf3U2vvB2QfYPYOyTll0lluF6mMtLHj8OibqEw%3D&reserved=0 with a further publication submitted for peer review.
AIM 2 - To undertake external validation of an updated prognostic tool LUMPO3
This study determined the reliability of LUMPO3 to predict survival after treatment for uveal melanoma when using external data from other ocular oncology centres. Anonymized data of 1836 UM patients from seven international ocular oncology centres were analysed with LUMPO3 to predict the 10-year survival for each patient in each external dataset. LUMPO3's ability to discriminate between UM patients who died of metastatic UM and those who were still alive was fair-to-good despite differences in data records and collection at the different centres.
Results of this study were published in: https://eur03.safelinks.protection.outlook.com/?url=http%3A%2F%2Furl6570.hra.nhs.uk%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbQne05VVe0UaW9iiRd6kqFoY1pvG-2BXvXCoOI5NFAv7QrgrP2AMMYIwf8KYME9nNjoQ-3D-3D3T3O_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YIu2IRSBEv2lZ2NCC5yzxlwkct4EtREa-2F2HDq-2FyAWWGCXZRTtYdK8NbDHeyEn89LtD6dJZts0nXwkvWjKhgXF8pIO1qvLSJvWrVXSFsIfyisCwGBBK71QkXu2eQw8CYwKygmcdheTVQwGLsomD63FAuTr762-2FbcjZK2Vt536jp6iQ-3D-3D&data=04%7C01%7Capprovals%40hra.nhs.uk%7Cc52c11fd25024e67915508da13fda416%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637844277341655518%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=jU6TPPPFVDeLIBrUUXx4d8cxhFHaSDnbHwbRphTkbwY%3D&reserved=0
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
18/NW/0748
Date of REC Opinion
21 Nov 2018
REC opinion
Favourable Opinion