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New risk assessment tools (RATs) aim to improve biopsy decision\u2010making. We constructed a modeling framework to assess new RATs in men with gray zone PSA from the British Columbia healthcare system's perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated the cost\u2010effectiveness of a new RAT used in biopsy\u2010na\u00efve men aged 50+ with a PSA of 3\u201310\u2009ng\/mL using a time\u2010dependent state\u2010transition model. The model was informed by engaging patient partners and using linked administrative health data, supplemented with published literature. The incremental cost\u2010effectiveness ratio and the probability of the RAT being cost\u2010effective were calculated. Probabilistic analysis was used to assess parameter uncertainty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the base case, a RAT based on an existing biomarker's characteristics was a dominant strategy associated with a cost savings of $44 and a quality\u2010adjusted life years (QALY) gain of 0.00253 over 18\u2009years of follow\u2010up. At a cost\u2010effectiveness threshold of $50,000\/QALY, the probability that using a RAT is cost\u2010effective relative to the SOC was 73%. Outcomes were sensitive to RAT costs and accuracy, especially the detection rate of high\u2010grade PCa. Results were also impacted by PCa prevalence and assumptions about undetected PCa survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings showed that a more accurate RAT to guide biopsy can be cost\u2010effective. Our proposed general model can be used to analyze the cost\u2010effectiveness of any novel RAT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6587","type":"journal-article","created":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T07:53:37Z","timestamp":1695455617000},"page":"20106-20118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Economic evaluation of prostate cancer risk assessment methods: A cost\u2010effectiveness analysis using population data"],"prefix":"10.1002","volume":"12","author":[{"given":"Tima","family":"Mohammadi","sequence":"first","affiliation":[{"name":"Centre for Advancing Health Outcomes (formerly Centre for Health Evaluation and Outcome Sciences), Providence Health Care Research Institute St. Paul's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne P.","family":"Guh","sequence":"additional","affiliation":[{"name":"Centre for Advancing Health Outcomes (formerly Centre for Health Evaluation and Outcome Sciences), Providence Health Care Research Institute St. Paul's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3359-5552","authenticated-orcid":false,"given":"Alexander C. 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