Estudio de coste-efectividad del diagnóstico microbiológico de tuberculosis mediante geneXpert MTB/RIF ®

Herráez, Óscar; Asencio-Egea, María Ángeles; Huertas-Vaquero, María; Carranza-González, Rafael; Castellanos-Monedero, J.J.; Franco-Huerta, María; Barberá-Farré, José Ramón; Tenias, Jose María

doi:10.1016/j.eimc.2016.06.009

Cited by 10 publications

(8 citation statements)

References 15 publications

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“…The target population consisted of patients presenting with symptoms of active pulmonary TB disease [ 38 – 43 , 47 ], in some cases, patients with human immunodeficiency virus specifically [ 44 – 46 , 48 ]. The comparators were sputum smear microscopy [ 38 – 41 , 45 ], culture [ 42 – 44 ] and chest radiography [ 41 , 43 , 45 ]. In the case of testing positive, the treatment was a routine TB regime.…”

Section: Resultsmentioning

confidence: 99%

“…Time horizons considered were 6 months [ 45 ], 2 months [ 48 ] or lifetime [ 46 , 47 ]. The clinical outcomes used were QALYs [ 40 , 42 , 47 , 48 ], DALYs [ 41 , 46 ], TB cases detected [ 38 , 39 , 46 , 47 ], days free from disease [ 44 ] and deaths averted [ 45 ]. One analysis included multi-drug resistance into the model as they switched to a second-line treatment if rifampicin resistance was identified [ 41 ].…”

Section: Resultsmentioning

confidence: 99%

“…One study concluded that the delay in diagnosing active TB caused the test strategy not to be cost effective [ 48 ]. Other studies showed that the combination of Xpert with LF-LAM was cost effective compared with the usual care [ 40 , 42 , 46 ] and testing was the most cost-effective strategy while varying the incidence of TB (even when as low as 0.2%) [ 47 ]. Uncertainty was included using deterministic [ 38 – 45 , 47 ] and probabilistic sensitivity analyses [ 39 – 43 , 45 – 48 ].…”

Section: Resultsmentioning

confidence: 99%

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Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review

et al. 2021

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Background Diagnostic testing for respiratory tract infections is a tool to manage the current COVID-19 pandemic, as well as the rising incidence of antimicrobial resistance. At the same time, new European regulations for market entry of in vitro diagnostics, in the form of the in vitro diagnostic regulation, may lead to more clinical evidence supporting health-economic analyses. Objective The objective of this systematic review was to review the methods used in economic evaluations of applied diagnostic techniques, for all patients seeking care for infectious diseases of the respiratory tract (such as pneumonia, pulmonary tuberculosis, influenza, sinusitis, pharyngitis, sore throats and general respiratory tract infections). Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles from three large databases of scientific literature were included (Scopus, Web of Science and PubMed) for the period January 2000 to May 2020. Results A total of 70 economic analyses are included, most of which use decision tree modelling for diagnostic testing for respiratory tract infections in the community-care setting. Many studies do not incorporate a generally comparable clinical outcome in their cost-effectiveness analysis: fewer than half the studies (33/70) used generalisable outcomes such as qualityadjusted life-years. Other papers consider outcomes related to the accuracy of the test or outcomes related to the prescribed treatment. The time horizons of the studies generally are limited. Conclusions The methods to economically assess diagnostic tests for respiratory tract infections vary and would benefit from clear recommendations from policy makers on the assessed time horizon and outcomes used.Simon van der Pol and Paula Rojas Garcia contributed equally to the article.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review

et al. 2021

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“…Of note, this extra cost would have been substantially reduced or even eliminated had the recommended number of sputum specimens for TB diagnosis (no less than two and preferably three) been provided in all the cases in our cohort (Table 1). In any case, this amount would be insignificant if the cost savings from implementing routine PCR testing in TB diagnostic algorithms predicted by modeling studies are confirmed (4,5,14,15,(36)(37)(38). Regarding NTM recovery, the incidence of clinically significant NTM lung disease is low in most high-income countries (39,40) and its risk factors in adults have been reasonably delineated (39)(40)(41)(42)(43).…”

Section: Discussionmentioning

confidence: 99%

“…Fourth, the majority of the patients came from a single tertiary care hospital and about 45% of the patients were hospitalized. Fifth, we did not analyze the health system benefits or overall cost-effectiveness of our proposed diagnostic algorithm because of the low number of TB patients in the cohort and the lack of a consensus method to perform overall cost-effectiveness studies (36).…”

Section: Discussionmentioning

confidence: 99%

Performance of a Highly Sensitive Mycobacterium tuberculosis Complex Real-Time PCR Assay for Diagnosis of Pulmonary Tuberculosis in a Low-Prevalence Setting: a Prospective Intervention Study

et al. 2018

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The potential impact of routine real-time PCR testing of respiratory specimens from patients with presumptive tuberculosis in terms of diagnostic accuracy and time to tuberculosis treatment inception in low-prevalence settings remains largely unexplored. We conducted a prospective intervention cohort study. Respiratory specimens from 1,020 patients were examined by acid-fast bacillus smear microscopy, tested by a real-time complex PCR assay (Abbott RealTi MTB PCR), and cultured in mycobacterial media. Seventeen patients tested positive by PCR (5 were acid-fast bacillus smear positive and 12 acid-fast bacillus smear negative), and was recovered from cultures for 12 of them. Patients testing positive by PCR and negative by culture ( = 5) were treated and deemed to have responded to antituberculosis therapy. There were no PCR-negative/culture-positive cases, and none of the patients testing positive for nontuberculous mycobacteria ( = 20) yielded a positive PCR result. The data indicated that routine testing of respiratory specimens from patients with presumptive tuberculosis by the RealTi MTB PCR assay improves the tuberculosis diagnostic yield and may reduce the time to antituberculosis treatment initiation. On the basis of our data, we propose a novel mycobacterial laboratory algorithm for tuberculosis diagnosis.

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Diagnóstico microbiológico actual de la tuberculosis

Alcaide

2017

Enfermedades Infecciosas y Microbiología Clínica

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Estudio de coste-efectividad del diagnóstico microbiológico de tuberculosis mediante geneXpert MTB/RIF ®

Cited by 10 publications

References 15 publications

Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review

Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review

Performance of a Highly Sensitive Mycobacterium tuberculosis Complex Real-Time PCR Assay for Diagnosis of Pulmonary Tuberculosis in a Low-Prevalence Setting: a Prospective Intervention Study

Diagnóstico microbiológico actual de la tuberculosis

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