Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 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

Andrea Freyer Dugas  1 , Sara Coleman, Charlotte A Gaydos, Richard E Rothman, Kevin D Frick
Affiliations
Comparative Study

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

Andrea Freyer Dugas et al. Ann Emerg Med. 2013 Jul.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Overview of decision tree.
Figure 2
Figure 2
One-way sensitivity analysis of influenza prevalence. ICER comparing treatment according to provider judgment with treatment according to a rapid PCR test and treatment according to provider judgment to treat all, compared with the accepted willingness-to-pay threshold of $50,000 per QALY.
Figure 3
Figure 3
Tornado diagram displaying ICER between treatment according to rapid PCR-based influenza testing and treat all algorithms.
Figure 4
Figure 4
Cost-effectiveness acceptability curve of Monte Carlo simulation results across a range of willingness-to-pay thresholds.
See this image and copyright information in PMC

Comment in

References

    1. Centers for Disease Control and Prevention. Seasonal influenza. [Accessed March 12, 2013];2011 Available at: http://www.cdc.gov/flu/about/qa/disease.htm.
    1. Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289:179–186. - PubMed
    1. Thompson WW, Shay DK, Weintraub E, et al. Influenza-associated hospitalizations in the United States. JAMA. 2004;292:1333–1340. - PubMed
    1. Fiore AE, Fry A, Shay D, et al. Centers for Disease Control and Prevention (CDC). Antiviral agents for the treatment and chemoprophylaxis of influenza—recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Surveill Summ. 2011;60:1–24. - PubMed
    1. Harper SA, Bradley JS, Englund JA, et al. Seasonal influenza in adults and children—diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2009;48:1003–1032. - PMC - PubMed

Publication types

MeSH terms

Substances