Table 1

List of key parameter values and sources

InputValue in modelSource/notes
Proportion of presenting cohort by stage of lung cancer
Stage I54%Folch et al12
Stage II11%
Stage III17%
Stage IV18%
Survival and disease progression
All-cause mortalityVariousAge and sex adjusted, ONS13
Annual probability of death with treatment (by stage at diagnosis)
Stage I0.1032Derived from information in Cancer Research UK (2014)8
Stage II0.1857
Stage III0.3180
Stage IV0.4043
Monthly probability of disease progression without treatment
Stage I and II to stage III0.05Informed by information in Hinde et al14
Stage I and II to stage IV0.10
Stage III to IV0.20
Death0.01Assumed to have the same survival as patients with stage I cancer. Cancer Research UK (2014)8
Probability of adverse events
ENB-related pneumothorax (requiring intervention)2.88%Folch et al12
ENB-related pneumothorax (not requiring intervention)1.40%
ENB pulmonary haemorrhage1.48%
TTNA-related pneumothorax (requiring intervention)7.28%DiBardino et al16
TTNA-related pneumothorax (not requiring intervention)13.20%
TTNA pulmonary haemorrhage2.73%
No cancer utility0.855Szende et al18
Stage I utility0.825Based on the pooled estimate of non-metastatic NSCLC, Sturza17
Stage II utility0.825Assumed equivalent to stage I cancer. Sturza17
Stage III utility0.772Based on the pooled estimate of mixed/not specified NSCLC. Sturza (2010)17
Stage IV utility0.537Based on the pooled estimate of metastatic NSCLC. Sturza (2010)17
Relative decrement for age0.912Based on utility value of 0.78 for a 70 year old. Kind et al (1999)19
Disutility of pneumothorax−0.1388SMDM29. Disutility applied for a 2-month duration (assumed)
Disutility of haemorrhage−0.0821
Intervention procedural costs
ENB£1942Estimated via a micro costing (see table 2)
TTNA£1630Calculated by adding the costs of the image-guided biopsy of lesion muscle of connective tissue (£1481) (Total HRG code: YH32A) and the cost of the full pulmonary function testing (£150) (Total HRG code: DZ52Z)22
Adverse event costs
Haemorrhage£3127Assumed equivalent to non-elective tracheostomy code: CA63Z22
Pneumothorax (requiring intervention)£2939Average cost of non-elective pneumothorax treatment with single or multiple interventions. Codes: DZ26G to
Pneumothorax (not requiring intervention)£1286Average cost of non-elective pneumothorax without Interventions. Codes: Z26M to DZ26P22
Cost of false negative (delayed diagnosis)
Cost of CT scan£106CT scan of two areas, with contrast. Code: RD24Z22
Cost of GP appointment£37PSSRU 201821
Annual cost of each stage of cancer: inflated to 2017/2018 (original value)
Stage I non-resected cancer£8267 (£7952)Cancer Research UK30
Stage II non-resected cancer£8679 (£8349)
Stage III non-resected cancer£9078 (£8733)
Stage IV non-resected cancer£13 595 (£13 078)
  • *Please note utilities were age adjusted throughout the lifetime of the cohort.

  • ENB, electromagnetic navigation bronchoscopy; HRQoL, health-related quality of life; NSCLC, non-small-cell lung carcinoma; ONS, Office for National Statistics; TTNA, transthoracic needle aspiration.