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Ann Emerg Med. 2013 Jul;62(1):80-8. doi: 10.1016/j.annemergmed.2013.01.005. Epub 2013 Mar 20.

Cost-utility of rapid polymerase chain reaction-based influenza testing for high-risk emergency department patients.

Author information

1
Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA. adugas1@jhmi.edu

Abstract

STUDY OBJECTIVE:

We evaluate the cost-effectiveness of polymerase chain reaction (PCR)-based rapid influenza testing and treatment for influenza in adult emergency department (ED) patients who are at high risk for or have evidence of influenza-related complications.

METHODS:

We developed a cost-utility decision analysis model that assessed adult patients presenting to the ED with symptoms of an acute respiratory infection, who met the Centers for Disease Control and Prevention criteria for recommended antiviral treatment. Analysis was performed from the societal perspective, with incremental comparisons of 4 influenza testing and treatment strategies: treat none, treat according to provider judgment, treat according to results of a PCR-based rapid diagnostic test, and treat all.

RESULTS:

Treating no patients with antivirals was dominated by all other strategies that increased in both cost and benefit in the following order: treat according to provider judgment, treat according to results of a PCR-based rapid diagnostic test, and treat all. As influenza prevalence increases, treating all patients eventually dominated all other options.

CONCLUSION:

The economic benefit of incorporating use of rapid PCR-based influenza testing for ED patients at risk of developing influenza-related complications depends on influenza prevalence; treatment guided by physician diagnosis or rapid testing, and treatment of all patients is more effective and less costly than no treatment.

PMID:
23522607
PMCID:
PMC4162424
DOI:
10.1016/j.annemergmed.2013.01.005
[Indexed for MEDLINE]
Free PMC Article

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