| Serologic testing for syphilis in the United States: a cost-effectiveness analysis of two screening algorithms. | |
| | |
MedLine Citation:
|
PMID: 20739911 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
BACKGROUND: The introduction of automated treponemal enzyme immunoassays and chemiluminescence assays (EIA/CA) tests has led some laboratories in the United States to use new syphilis screening algorithms that start with a treponemal test. We compared the economic and health outcomes of this new algorithm with the standard algorithm from the perspective of the United States health system. METHODS: We used a cohort decision analysis to estimate the expected costs and effects (including follow-ups and overtreatment) of the 2 algorithms from a health-care system perspective. In the standard algorithm, rapid plasma reagin (RPR) is followed (if reactive) by EIA/CA (Nontreponemal-First). In the new algorithm, EIA/CA is followed (if reactive) by RPR. If the RPR is negative, Treponema pallidum passive particle agglutination assay (TP-PA) test is used (Treponemal-First). RESULTS: For a cohort of 200,000 individuals (1000 current infections and 10,000 previous infections), the net costs were $1.6 m (Treponemal-First) and $1.4 m (Nontreponemal-First). The Treponemal-First option treated 118 more cases (986 vs. 868) but resulted in a substantially higher number of follow-ups (11,450 vs. 3756) and overtreatment (964 vs. 38). Treating the additional 118 cases might prevent 1 case of tertiary syphilis. The estimated cost-effectiveness ratios were $1671 (Treponemal-First) and $1621 (Nontreponemal-First) per case treated. The overtreatment was a function of the specificity of the EIA/CA and the lack of independence of EIA/CA and TP-PA. CONCLUSION: The Treponemal-First option costs slightly more and results in more unnecessary treatment. |
| | |
Authors:
|
Kwame Owusu-Edusei; Thomas A Peterman; Ronald C Ballard |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Sexually transmitted diseases Volume: 38 ISSN: 1537-4521 ISO Abbreviation: Sex Transm Dis Publication Date: 2011 Jan |
Date Detail:
|
Created Date: 2010-12-15 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7705941 Medline TA: Sex Transm Dis Country: United States |
Other Details:
|
Languages: eng Pagination: 1-7 Citation Subset: IM |
Affiliation:
|
Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-80, Atlanta, GA 30333, USA. kowusuedusei@cdc.gov |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Longitudinal examination of alcohol use: a predictor of risky sexual behavior and Trichomonas vagina...
Next Document: Reinfections during the Florida syphilis epidemic, 2000-2008.