{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:30:45Z","timestamp":1791570645553,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As antimicrobial resistance increases, safer alternative approaches to prostate biopsy are needed. PREVENT was a multi\u2010institutional, randomized controlled trial comparing transperineal (TP) biopsy without antibiotic prophylaxis versus transrectal (TR) biopsy with targeted prophylaxis. The authors conducted a secondary cost\u2010effectiveness analysis of PREVENT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors designed a Markov model with a simulated cohort of 1000 biopsied men. They assessed the short\u2010term cost\u2010effectiveness over a 2\u2010week period, comparing relative costs in US dollars and utility measured in quality\u2010adjusted life years (QALYs). The strategies they compared were office\u2010based, magnetic resonance imaging\u2010guided biopsy using two approaches: (1) TP without antibiotics; or (2) TR with targeted antibiotic prophylaxis. Analysis was from a health care payer perspective using a willingness\u2010to\u2010pay (WTP) threshold of $100,000\/QALY. Probabilistic sensitivity analysis was performed with 5000 Monte Carlo simulations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to TR, TP was dominant, offering lower cost and higher utility per patient. This finding was robust to sensitivity analyses with TP having &gt;89% probability of cost\u2010effectiveness regardless of WTP threshold. TP remained dominant when real\u2010world infection rates were used. TP biopsy needed to prevent &gt;0.5% infections compared to TR to maintain cost\u2010effectiveness. Per 1000 patients, TP biopsy prevented 16 infections, and the additional cost to prevent a single infection was $3.18\/patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this model, TP biopsy was more cost\u2010effective than TR from a health care payer perspective. In the setting of increasing concerns about the risk of infection from traditional TR biopsy, these findings suggest that office\u2010based TP biopsy is a more cost\u2010effective population\u2010level alternative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70118","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:47:47Z","timestamp":1761698867000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cost\u2010effectiveness of office\u2010based, magnetic resonance imaging\u2010guided transperineal versus transrectal prostate biopsy: An economic analysis of the PREVENT trial"],"prefix":"10.1002","volume":"131","author":[{"given":"Mitchell M.","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Urology Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7730-6145","authenticated-orcid":false,"given":"Conor B.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Department of Urology Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Urology Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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