The working flow chart for eligible study identification in meta-analysis studies.

<p>The working flow chart for eligible study identification in meta-analysis studies.</p

The dose-relationship between the caffeinated coffee intake (cups/day) and the MM risk compared to non-drinkers (P for non-linearity = 0.326).

<p>The dose-relationship between the caffeinated coffee intake (cups/day) and the MM risk compared to non-drinkers (P for non-linearity = 0.326).</p

Higher Caffeinated Coffee Intake Is Associated with Reduced Malignant Melanoma Risk: A Meta-Analysis Study

<div><p>Background</p><p>Several epidemiological studies have determined the associations between coffee intake level and skin cancer risk; however, the results were not yet conclusive. Herein, we conducted a systematic review and meta-analysis of the cohort and case-control studies for the association between coffee intake level and malignant melanoma (MM) risk.</p><p>Methods</p><p>Studies were identified through searching the PubMed and MEDLINE databases (to November, 2015). Study-specific risk estimates were pooled under the random-effects model.</p><p>Results</p><p>Two case-control studies (846 MM patients and 843 controls) and five cohort studies (including 844,246 participants and 5,737 MM cases) were identified. For caffeinated coffee, the pooled relative risk (RR) of MM was 0.81 [95% confidential interval (95% CI) = 0.68–0.97; P-value for Q-test = 0.003; I² = 63.5%] for those with highest versus lowest quantity of intake. In the dose-response analysis, the RR of MM was 0.955 (95% CI = 0.912–0.999) for per 1 cup/day increment of caffeinated coffee consumption and linearity dose-response association was found (P-value for nonlinearity = 0.326). Strikingly, no significant association was found between the decaffeinated coffee intake level and MM risk (pooled RR = 0.92, 95% CI = 0.81–1.05; P-value for Q-test = 0.967; I² = 0%; highest versus lowest quantity of intake).</p><p>Conclusions</p><p>This meta-analysis suggested that caffeinated coffee might have chemo-preventive effects against MM but not decaffeinated coffee. However, larger prospective studies and the intervention studies are warranted to confirm these findings.</p></div

The relative risks (RRs) of melanoma for the highest versus lowest quantity of decaffeinated coffee intake in case-control studies and cohort studies.

<p>The square represents the study-specific RR and the size of the squares reflects the statistical weight in the meta-analysis; horizontal lines represent the 95% confidential intervals (95% CIs); the diamond indicates the overall RR with its 95% CI under the random-effects model.</p

The stratification studies for the associations between caffeinated coffee or decaffeinated coffee intake level (highest vs. lowest percentile) and the risk for melanoma.

<p>The stratification studies for the associations between caffeinated coffee or decaffeinated coffee intake level (highest vs. lowest percentile) and the risk for melanoma.</p

Results of the survival curve fit the Sorafenib of the base-case analysis in the partitioned survival model.

Results of the survival curve fit the Sorafenib of the base-case analysis in the partitioned survival model.</p

Results of the survival curve fit the Tislelizumab of the base-case analysis in the partitioned survival model.

Results of the survival curve fit the Tislelizumab of the base-case analysis in the partitioned survival model.</p

Model parameters: Baseline values, ranges, and distributions for sensitivity analysis.

Model parameters: Baseline values, ranges, and distributions for sensitivity analysis.</p

Incremental cost-effectiveness scatter plot.

BackgroundTo evaluate the cost-effectiveness of Tislelizumab vs Sorafenib as the first-line treatment of unresectable hepatocellular carcinoma (HCC) from the perspective of the Chinese health service system.MethodsA lifetime partitioned survival model (PSM) was developed to cost-effectively analyze Tislelizumab vs Sorafenib as the first-line treatment of unresectable HCC. The clinical and safety data were derived from a recently randomized clinical trial (RATIONALE-301). Utilities were collected from the published literature. Costs were obtained from an open-access database (http://www.yaozh.com) and previous studies. The model cycle was 21 days, according to the RATIONALE-301 study, and the simulation period was patients’ lifetime. Long-term direct medical costs and quality-adjusted life-years (QALYs) were determined. The incremental cost-effectiveness ratio (ICER) was used as the evaluation index. one-way sensitivity analysis (OSWA) and probabilistic sensitivity analysis (PSA) were used to analyze the uncertainty of parameters and to adjust and verify the stability of the baseline results.ResultsThe Tislelizumab group generated a cost of $39,746.34 and brought health benefits to 2.146 QALYs, while the cost and utility of the Sorafenib group were$26750.95 and 1.578 QALYs, respectively. The Tislelizumab group increased QALYs by 0.568, the incremental cost was $12995.39, and the ICER was$22869.64/QALY, lower than the willingness to pay threshold (WTP). OSWA results showed that the utility of progressed disease (PD), cost of Camrelizumab, and cost of Tislelizumab were the main factors affecting the ICER. PSA results showed that, within 1000 times the Monte Carlo simulation, the cost of the Tislelizumab group was lower than three times the per capita gross domestic product (GDP) of China ($37653/QALY). The cost-effectiveness acceptability curves (CEAC) revealed that when WTP was no less than$12251.00, the Tislelizumab group was the dominant scheme, and the economic advantage grew with an increasing WTP. When WTP ≥ $19000.00, the Tislelizumab group became the absolute economic advantage.ConclusionUnder the current economic conditions in China, the Tislelizumab therapeutic scheme is more cost-effective than the Sorafenib therapeutic scheme for treating patients with unresectable HCC.</div

The one-way sensitivity analysis results presented by tornado diagram.

The one-way sensitivity analysis results presented by tornado diagram.</p