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. 2011 Jun 6:8:277.
doi: 10.1186/1743-422X-8-277.

Determination of the relative economic impact of different molecular-based laboratory algorithms for respiratory viral pathogen detection, including Pandemic (H1N1), using a secure web based platform

Bonita E Lee  1 , Shamir N Mukhi, Jennifer May-Hadford, Sabrina Plitt, Marie Louie, Steven J Drews
Affiliations

Determination of the relative economic impact of different molecular-based laboratory algorithms for respiratory viral pathogen detection, including Pandemic (H1N1), using a secure web based platform

Bonita E Lee et al. Virol J. .

Abstract

Background: During period of crisis, laboratory planners may be faced with a need to make operational and clinical decisions in the face of limited information. To avoid this dilemma, our laboratory utilizes a secure web based platform, Data Integration for Alberta Laboratories (DIAL) to make near real-time decisions.This manuscript utilizes the data collected by DIAL as well as laboratory test cost modeling to identify the relative economic impact of four proposed scenarios of testing for Pandemic H1N1 (2009) and other respiratory viral pathogens.

Methods: Historical data was collected from the two waves of the pandemic using DIAL. Four proposed molecular testing scenarios were generated: A) Luminex respiratory virus panel (RVP) first with/without US centers for Disease Control Influenza A Matrix gene assay (CDC-M), B) CDC-M first with/without RVP, C) RVP only, and D) CDC-M only. Relative cost estimates of different testing algorithm were generated from a review of historical costs in the lab and were based on 2009 Canadian dollars.

Results: Scenarios A and B had similar costs when the rate of influenza A was low (< 10%) with higher relative cost in Scenario A with increasing incidence. Scenario A provided more information about mixed respiratory virus infection as compared with Scenario B.

Conclusions: No one approach is applicable to all conditions. Testing costs will vary depending on the test volume, prevalence of influenza A strains, as well as other circulating viruses and a more costly algorithm involving a combination of different tests may be chosen to ensure that tests results are returned to the clinician in a quicker manner. Costing should not be the only consideration for determination of laboratory algorithms.

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Figures

Figure 1
Figure 1
Scenario A - RVP with/without CDC-M.
Figure 2
Figure 2
Scenario B - CDC-M with/without RVP.
Figure 3
Figure 3
Scenario C - RVP only.
Figure 4
Figure 4
Scenario D - CDC-M only.
Figure 5
Figure 5
Rate of specimens positive for respiratory virus(es), influenza A and Pandemic H1N1 (2009) and the relative total weekly test cost per specimen for Scenarios A-D during April 19 2009 to April 24, 2010. The relative cost of each algorithm is calculated as the ratio of each algorithm to the lowest cost of any algorithm for the same time period.
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References

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