{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:24:09Z","timestamp":1792794249378,"version":"4.5.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"1169","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Technology Wales"},{"name":"Swansea Centre for Health Economics"},{"name":"Health and Care Economics Cymru"},{"DOI":"10.13039\/100012068","name":"Health and Care Research Wales","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012068","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015846","name":"Welsh Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015846","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012068","name":"Health and Care Research Wales","doi-asserted-by":"publisher","award":["NHS.RTA-19-09"],"award-info":[{"award-number":["NHS.RTA-19-09"]}],"id":[{"id":"10.13039\/100012068","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Velindre Cancer Centre","id":[{"id":"https:\/\/ror.org\/049sr1d03","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Gallbladder polyps (GBPs) are commonly detected with trans-abdominal ultrasound (TAUS). Gallbladder cancer (GBC) is associated with GBPs but the risk of malignancy is low. International guidelines recommend ultrasound surveillance (USS) in selected cases of GBPs &amp;lt;10 mm, with cholecystectomy advised if the polyp size increases. USS (including potential cholecystectomies) is resource intense. We evaluated the costs and potential cost-effectiveness of USS in a theoretical UK patient cohort with GBPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A health economic model mapped expected management pathways over 2 years for 1000 GBP patients with and without USS, stratified by the initial size of GBP (&amp;lt;6 mm and 6\u20139 mm). We estimated USS resource and costs under alternate referral thresholds for cholecystectomy. Clinical data were extracted from a large-scale cohort study. TAUS and cholecystectomy costs were based on NHS tariffs. GBC costs were estimated from the literature. Outcomes included USS costs, expected numbers of GBC, and incremental cost for each case of GBC avoided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 2-year additional cohort costs of USS (n\u2009=\u2009number of cholecystectomies) were estimated between \u00a3213\u2009441 (n\u2009=\u200950) and \u00a3750\u2009045 (n\u2009=\u2009253) in GBPs &amp;lt;6 mm and between \u00a3420\u2009275 (n\u2009=\u2009165) and \u00a3531\u2009297 (n\u2009=\u2009207) in GBPs 6\u20139 mm, balanced against avoidance of 1.3 (&amp;lt;6 mm) and 8.7 (6\u20139 mm) cases of GBC. Model findings were robust to plausible changes in inputs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using published data, we demonstrated that, in patients with GBPs &amp;lt;10 mm, the costs of USS to avoid GBC outweigh potential GBC cost offsets and would result in high rates of cholecystectomy. Additional evidence is needed to establish the formal cost-effectiveness of GBP USS in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>\u2022 We developed a health economic model, based on published data, to evaluate the cost-effectiveness of guideline-recommended ultrasound surveillance (USS) in patients with gallbladder polyps measuring less than 10 mm in the UK.<\/jats:p>\n                    <jats:p>\u2022 The analysis provides a transparent platform to explore potential numbers of trans-abdominal ultrasound studies and cholecystectomies that might be expected if USS protocols are adhered to and discovers important gaps in current evidence that could be filled by additional targeted research.<\/jats:p>\n                  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