Researchers at the University of Cincinnati have found that high-resolution computed tomography (CT) scans are cost-effective when screening for lymphangioleiomyomatosis (LAM) in nonsmoking women between ages 25 and 54 who come to the emergency room for the first time with a collapsed lung. About one third of LAM patients develop a spontaneous pneumothorax as the first major sign.
The study published in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine looked at rates of collapsed lung and prevalence of LAM in relation to age, gender, and smoking status. It compared the benefit and cost of using high-resolution CT screening following lung collapse for patients with LAM to no CT screening.
“Screening for LAM using a high-resolution CT, or three-dimensional X-ray of the lungs, is the most cost-effective strategy, with approximately $32,000 per quality-adjusted life year gained,” said Brent Kinder, MD, assistant professor of medicine and director of the University of Cincinnati Interstitial Lung Disease Center and a study investigator. “For comparison, hemodialysis, a standard benchmark for cost-effectiveness, costs about $50,000 per quality-adjusted life year gained. With this data, physicians will be able to intervene with therapies more quickly and enroll patients in clinical trials that may be able to slow progression of the disease.”
Pulmonary LAM, a rare but serious lung disease, occurs when smooth muscle tissue proliferates within the interstitium of the lung in the form of characteristic thin-walled lung cysts. Many patients present with shortness of breath, which is often misdiagnosed as asthma.
“Women with LAM who first experience spontaneous lung collapse will, on average, experience two more, but diagnosis doesn’t usually occur until the second or third collapse, delaying treatment,” said Kinder.