Comparative effectiveness of a rapid point-of-care test for detection of Chlamydia trachomatis among women in a clinical setting
Objectives To compare the effectiveness and cost-effectiveness of a promising new point-of-care (POC) chlamydia test with traditional nucleic acid amplification testing (NAAT), and to determine the characteristics that would make a POC test most cost-effective. Methods A decision tree was constructe...
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| Veröffentlicht in: | Sexually transmitted infections 2013-03, Vol.89 (2), p.108-114 |
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| creator | Huang, Wei Gaydos, Charlotte A Barnes, Mathilda R Jett-Goheen, Mary Blake, Diane R |
| description | Objectives To compare the effectiveness and cost-effectiveness of a promising new point-of-care (POC) chlamydia test with traditional nucleic acid amplification testing (NAAT), and to determine the characteristics that would make a POC test most cost-effective. Methods A decision tree was constructed to model chlamydia screening visits to a sexually transmitted disease clinic by a hypothetical cohort of 10 000 women. The model incorporated programmatic screening costs, treatment costs and medical costs averted through prevention of pelvic inflammatory disease (PID) and its sequelae. Parameter values and costs were estimated for each node in the decision tree based on primary data, published data and unpublished health data. Results For the base-case scenario (POC sensitivity 92.9%; 47.5% of women willing to wait 40 min for test results; test cost $33.48), POC was estimated to save US$5050 for each case of PID averted compared with NAAT. One-way sensitivity analyses indicated that POC would dominate NAAT if the POC test cost is |
| doi_str_mv | 10.1136/sextrans-2011-050355 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3671871</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4026624691</sourcerecordid><originalsourceid>FETCH-LOGICAL-b531t-b079d0582c65cd9b0b6b9e69ceef6ff59fa8c05a013ea7e8a8e375378ed037153</originalsourceid><addsrcrecordid>eNqNkk2LFDEQhhtR3HX1H4gERPDSbtLpfF0EGVwVlhVExVtIpyszGbuT2aRn3b35083Ys-PHRU8pqKde3lS9VfWY4BeEUH6a4XpKJuS6wYTUmGHK2J3qmLSiqWnD6d1SUy7rVgl6VD3IeY0x5oKp-9VR0yjZYsmOq--LOG5MMpO_AgTOgd1VAXJG0SGDktn4Hm2iD1MdXW1NAjRBnpCLCfUw7fgYduxiNZjxpvcGFVt2FceimZEZY1iib3GEgHwognbwwVszoAzT5MPyYXXPmSHDo_17Un06e_1x8bY-f__m3eLVed0xSqa6w0L1mMnGcmZ71eGOdwq4sgCOO8eUM9JiZjChYARII4EKRoWEHlNBGD2pXs66m203Qm8hFJuD3iQ_mnSjo_H6z07wK72MV5pyQaQgReD5XiDFy21ZgR59tjAMJkDcZk0YI5y2Uqh_o40iHDMumoI-_Qtdx20KZROaCEm44orxQrUzZVPMOYE7-CZY79Kgb9Ogd2nQcxrK2JPf_3wYuj1_AZ7tAZPLTVxRsD7_4gTmRP4UqmfO5wmuD32Tvmouyp71xeeFxvziwxkTXH8p_OnMd-P6_6z-ACD04GY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1781696956</pqid></control><display><type>article</type><title>Comparative effectiveness of a rapid point-of-care test for detection of Chlamydia trachomatis among women in a clinical setting</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Huang, Wei ; Gaydos, Charlotte A ; Barnes, Mathilda R ; Jett-Goheen, Mary ; Blake, Diane R</creator><creatorcontrib>Huang, Wei ; Gaydos, Charlotte A ; Barnes, Mathilda R ; Jett-Goheen, Mary ; Blake, Diane R</creatorcontrib><description>Objectives To compare the effectiveness and cost-effectiveness of a promising new point-of-care (POC) chlamydia test with traditional nucleic acid amplification testing (NAAT), and to determine the characteristics that would make a POC test most cost-effective. Methods A decision tree was constructed to model chlamydia screening visits to a sexually transmitted disease clinic by a hypothetical cohort of 10 000 women. The model incorporated programmatic screening costs, treatment costs and medical costs averted through prevention of pelvic inflammatory disease (PID) and its sequelae. Parameter values and costs were estimated for each node in the decision tree based on primary data, published data and unpublished health data. Results For the base-case scenario (POC sensitivity 92.9%; 47.5% of women willing to wait 40 min for test results; test cost $33.48), POC was estimated to save US$5050 for each case of PID averted compared with NAAT. One-way sensitivity analyses indicated that POC would dominate NAAT if the POC test cost is <US$41.52 or if POC sensitivity is ≥87.1%. In a probabilistic sensitivity analysis (Monte Carlo simulations, 10 000 iterations), 10.8% of iterations indicated that the POC strategy dominated the NAAT strategy. The mean incremental cost-effectiveness ratio indicated that the POC strategy would save US$28 in total, and avert 14 PID cases. Conclusions A promising new chlamydia POC test is likely to be cost-effective compared with traditional NAAT. The POC test sensitivity, cost and proportion of women willing to wait for the POC test result are key elements to determining the cost-effectiveness of any new POC test strategy.</description><identifier>ISSN: 1368-4973</identifier><identifier>ISSN: 1472-3263</identifier><identifier>EISSN: 1472-3263</identifier><identifier>DOI: 10.1136/sextrans-2011-050355</identifier><identifier>PMID: 22984085</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Adolescent ; Adult ; Antibiotics ; Asymptomatic ; Bacterial diseases ; Bacterial diseases of the genital system ; Biological and medical sciences ; Chlamydia ; Chlamydia Trachomatis ; Chlamydia trachomatis - isolation & purification ; Clinical Laboratory Techniques - economics ; Clinical Laboratory Techniques - methods ; Cost-Effectiveness ; Costs ; Costs and Cost Analysis ; Decision trees ; Diagnostic Tests, Routine - economics ; Diagnostic Tests, Routine - methods ; Epidemiology. Vaccinations ; Estimates ; FDA approval ; Female ; General aspects ; Health care expenditures ; Human bacterial diseases ; Human infectious diseases. Experimental studies and models ; Humans ; Infections ; Infectious diseases ; Infertility ; Lymphogranuloma Venereum - diagnosis ; Medical sciences ; Pelvic inflammatory disease ; Point-of-Care Systems - economics ; Pregnancy complications ; Screening ; Sexually transmitted diseases ; STD ; United States ; Vagina ; Womens health ; Young Adult</subject><ispartof>Sexually transmitted infections, 2013-03, Vol.89 (2), p.108-114</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>2014 INIST-CNRS</rights><rights>Copyright: 2013 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b531t-b079d0582c65cd9b0b6b9e69ceef6ff59fa8c05a013ea7e8a8e375378ed037153</citedby><cites>FETCH-LOGICAL-b531t-b079d0582c65cd9b0b6b9e69ceef6ff59fa8c05a013ea7e8a8e375378ed037153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://sti.bmj.com/content/89/2/108.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://sti.bmj.com/content/89/2/108.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,780,784,885,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27061855$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22984085$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Wei</creatorcontrib><creatorcontrib>Gaydos, Charlotte A</creatorcontrib><creatorcontrib>Barnes, Mathilda R</creatorcontrib><creatorcontrib>Jett-Goheen, Mary</creatorcontrib><creatorcontrib>Blake, Diane R</creatorcontrib><title>Comparative effectiveness of a rapid point-of-care test for detection of Chlamydia trachomatis among women in a clinical setting</title><title>Sexually transmitted infections</title><addtitle>Sex Transm Infect</addtitle><description>Objectives To compare the effectiveness and cost-effectiveness of a promising new point-of-care (POC) chlamydia test with traditional nucleic acid amplification testing (NAAT), and to determine the characteristics that would make a POC test most cost-effective. Methods A decision tree was constructed to model chlamydia screening visits to a sexually transmitted disease clinic by a hypothetical cohort of 10 000 women. The model incorporated programmatic screening costs, treatment costs and medical costs averted through prevention of pelvic inflammatory disease (PID) and its sequelae. Parameter values and costs were estimated for each node in the decision tree based on primary data, published data and unpublished health data. Results For the base-case scenario (POC sensitivity 92.9%; 47.5% of women willing to wait 40 min for test results; test cost $33.48), POC was estimated to save US$5050 for each case of PID averted compared with NAAT. One-way sensitivity analyses indicated that POC would dominate NAAT if the POC test cost is <US$41.52 or if POC sensitivity is ≥87.1%. In a probabilistic sensitivity analysis (Monte Carlo simulations, 10 000 iterations), 10.8% of iterations indicated that the POC strategy dominated the NAAT strategy. The mean incremental cost-effectiveness ratio indicated that the POC strategy would save US$28 in total, and avert 14 PID cases. Conclusions A promising new chlamydia POC test is likely to be cost-effective compared with traditional NAAT. The POC test sensitivity, cost and proportion of women willing to wait for the POC test result are key elements to determining the cost-effectiveness of any new POC test strategy.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antibiotics</subject><subject>Asymptomatic</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the genital system</subject><subject>Biological and medical sciences</subject><subject>Chlamydia</subject><subject>Chlamydia Trachomatis</subject><subject>Chlamydia trachomatis - isolation & purification</subject><subject>Clinical Laboratory Techniques - economics</subject><subject>Clinical Laboratory Techniques - methods</subject><subject>Cost-Effectiveness</subject><subject>Costs</subject><subject>Costs and Cost Analysis</subject><subject>Decision trees</subject><subject>Diagnostic Tests, Routine - economics</subject><subject>Diagnostic Tests, Routine - methods</subject><subject>Epidemiology. Vaccinations</subject><subject>Estimates</subject><subject>FDA approval</subject><subject>Female</subject><subject>General aspects</subject><subject>Health care expenditures</subject><subject>Human bacterial diseases</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Infertility</subject><subject>Lymphogranuloma Venereum - diagnosis</subject><subject>Medical sciences</subject><subject>Pelvic inflammatory disease</subject><subject>Point-of-Care Systems - economics</subject><subject>Pregnancy complications</subject><subject>Screening</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>United States</subject><subject>Vagina</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1368-4973</issn><issn>1472-3263</issn><issn>1472-3263</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkk2LFDEQhhtR3HX1H4gERPDSbtLpfF0EGVwVlhVExVtIpyszGbuT2aRn3b35083Ys-PHRU8pqKde3lS9VfWY4BeEUH6a4XpKJuS6wYTUmGHK2J3qmLSiqWnD6d1SUy7rVgl6VD3IeY0x5oKp-9VR0yjZYsmOq--LOG5MMpO_AgTOgd1VAXJG0SGDktn4Hm2iD1MdXW1NAjRBnpCLCfUw7fgYduxiNZjxpvcGFVt2FceimZEZY1iib3GEgHwognbwwVszoAzT5MPyYXXPmSHDo_17Un06e_1x8bY-f__m3eLVed0xSqa6w0L1mMnGcmZ71eGOdwq4sgCOO8eUM9JiZjChYARII4EKRoWEHlNBGD2pXs66m203Qm8hFJuD3iQ_mnSjo_H6z07wK72MV5pyQaQgReD5XiDFy21ZgR59tjAMJkDcZk0YI5y2Uqh_o40iHDMumoI-_Qtdx20KZROaCEm44orxQrUzZVPMOYE7-CZY79Kgb9Ogd2nQcxrK2JPf_3wYuj1_AZ7tAZPLTVxRsD7_4gTmRP4UqmfO5wmuD32Tvmouyp71xeeFxvziwxkTXH8p_OnMd-P6_6z-ACD04GY</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Huang, Wei</creator><creator>Gaydos, Charlotte A</creator><creator>Barnes, Mathilda R</creator><creator>Jett-Goheen, Mary</creator><creator>Blake, Diane R</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QL</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20130301</creationdate><title>Comparative effectiveness of a rapid point-of-care test for detection of Chlamydia trachomatis among women in a clinical setting</title><author>Huang, Wei ; Gaydos, Charlotte A ; Barnes, Mathilda R ; Jett-Goheen, Mary ; Blake, Diane R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b531t-b079d0582c65cd9b0b6b9e69ceef6ff59fa8c05a013ea7e8a8e375378ed037153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antibiotics</topic><topic>Asymptomatic</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the genital system</topic><topic>Biological and medical sciences</topic><topic>Chlamydia</topic><topic>Chlamydia Trachomatis</topic><topic>Chlamydia trachomatis - isolation & purification</topic><topic>Clinical Laboratory Techniques - economics</topic><topic>Clinical Laboratory Techniques - methods</topic><topic>Cost-Effectiveness</topic><topic>Costs</topic><topic>Costs and Cost Analysis</topic><topic>Decision trees</topic><topic>Diagnostic Tests, Routine - economics</topic><topic>Diagnostic Tests, Routine - methods</topic><topic>Epidemiology. Vaccinations</topic><topic>Estimates</topic><topic>FDA approval</topic><topic>Female</topic><topic>General aspects</topic><topic>Health care expenditures</topic><topic>Human bacterial diseases</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Infertility</topic><topic>Lymphogranuloma Venereum - diagnosis</topic><topic>Medical sciences</topic><topic>Pelvic inflammatory disease</topic><topic>Point-of-Care Systems - economics</topic><topic>Pregnancy complications</topic><topic>Screening</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><topic>United States</topic><topic>Vagina</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Wei</creatorcontrib><creatorcontrib>Gaydos, Charlotte A</creatorcontrib><creatorcontrib>Barnes, Mathilda R</creatorcontrib><creatorcontrib>Jett-Goheen, Mary</creatorcontrib><creatorcontrib>Blake, Diane R</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Sexually transmitted infections</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Wei</au><au>Gaydos, Charlotte A</au><au>Barnes, Mathilda R</au><au>Jett-Goheen, Mary</au><au>Blake, Diane R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative effectiveness of a rapid point-of-care test for detection of Chlamydia trachomatis among women in a clinical setting</atitle><jtitle>Sexually transmitted infections</jtitle><addtitle>Sex Transm Infect</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>89</volume><issue>2</issue><spage>108</spage><epage>114</epage><pages>108-114</pages><issn>1368-4973</issn><issn>1472-3263</issn><eissn>1472-3263</eissn><abstract>Objectives To compare the effectiveness and cost-effectiveness of a promising new point-of-care (POC) chlamydia test with traditional nucleic acid amplification testing (NAAT), and to determine the characteristics that would make a POC test most cost-effective. Methods A decision tree was constructed to model chlamydia screening visits to a sexually transmitted disease clinic by a hypothetical cohort of 10 000 women. The model incorporated programmatic screening costs, treatment costs and medical costs averted through prevention of pelvic inflammatory disease (PID) and its sequelae. Parameter values and costs were estimated for each node in the decision tree based on primary data, published data and unpublished health data. Results For the base-case scenario (POC sensitivity 92.9%; 47.5% of women willing to wait 40 min for test results; test cost $33.48), POC was estimated to save US$5050 for each case of PID averted compared with NAAT. One-way sensitivity analyses indicated that POC would dominate NAAT if the POC test cost is <US$41.52 or if POC sensitivity is ≥87.1%. In a probabilistic sensitivity analysis (Monte Carlo simulations, 10 000 iterations), 10.8% of iterations indicated that the POC strategy dominated the NAAT strategy. The mean incremental cost-effectiveness ratio indicated that the POC strategy would save US$28 in total, and avert 14 PID cases. Conclusions A promising new chlamydia POC test is likely to be cost-effective compared with traditional NAAT. The POC test sensitivity, cost and proportion of women willing to wait for the POC test result are key elements to determining the cost-effectiveness of any new POC test strategy.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>22984085</pmid><doi>10.1136/sextrans-2011-050355</doi><tpages>7</tpages></addata></record> |
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| ispartof | Sexually transmitted infections, 2013-03, Vol.89 (2), p.108-114 |
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| subjects | Adolescent Adult Antibiotics Asymptomatic Bacterial diseases Bacterial diseases of the genital system Biological and medical sciences Chlamydia Chlamydia Trachomatis Chlamydia trachomatis - isolation & purification Clinical Laboratory Techniques - economics Clinical Laboratory Techniques - methods Cost-Effectiveness Costs Costs and Cost Analysis Decision trees Diagnostic Tests, Routine - economics Diagnostic Tests, Routine - methods Epidemiology. Vaccinations Estimates FDA approval Female General aspects Health care expenditures Human bacterial diseases Human infectious diseases. Experimental studies and models Humans Infections Infectious diseases Infertility Lymphogranuloma Venereum - diagnosis Medical sciences Pelvic inflammatory disease Point-of-Care Systems - economics Pregnancy complications Screening Sexually transmitted diseases STD United States Vagina Womens health Young Adult |
| title | Comparative effectiveness of a rapid point-of-care test for detection of Chlamydia trachomatis among women in a clinical setting |
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