A Swedish cost-effectiveness analysis of community-based Chlamydia trachomatis PCR testing of postal urine specimens obtained at home

Abstract

Postal screening for C. trachomatis in an asymptomatic young population can be cost-effective only at prevalences higher than at present.

Chlamydia sequelae cost estimates used in current economic evaluations: does one-size-fit-all?

“…Three papers were from the UK (two from an English perspective,12 21 one from a Scottish perspective13), two from the Netherlands,14 22 two from Sweden15 23 and one each from Australia,24 Ireland,25 Denmark26 and Canada 27. One22 of the 11 papers selected cited sequelae management costs from previously published papers, so the latter two papers were also included 16 17.…”

“…In the three papers that had further breakdown of information about how costs were estimated,12 15 16 two considered management in inpatient settings only,12 16 and treatment was either using drug or surgery. None considered management by observation.…”

“…Management costs were in the region of £150–£400 in 8/12 papers 12 14 16 17 22 25–27. Cost was £21 in the paper from Scotland,13 and £1000 in one paper each from England21 and Sweden 15. Most of the studies with detailed breakdown on cost estimates considered 85%–90% management in outpatients.…”

Opportunistic testing for urogenital infection with Chlamydia trachomatis in south-western Switzerland, 2012: a feasibility study

“…The reported data differed for the denominators-the number of people who were eligible and invited to participate and the numerator-the number of people who responded, returned specimens or had valid results. No EU/EEA study had a response rate of over 80%, which has been applied as a criterion for a low risk of bias in other reviews [18]; only two had a response rate of over 70% [49,57] and six over 60% [48,49,53,57,63,79]. The response rate reported by the authors ranged from 12% to 71%.…”

“…<29 only 11 Denmark [42,45], the Netherlands [25,28,36], Norway [70,71], Sweden [49,52,53,54], UK [62] both <29 and >29 12 Denmark [41,45], Estonia [72], France [74], Germany [68], Slovenia [77], Spain [79], Sweden [48], UK [24,55,56,57] In terms of geographic coverage, five population-based studies included a nationally representative sample of the general adult population (France [74], Germany [68,69], the Netherlands [28], Slovenia [77], UK [57]), and one a similar sample of the child and adolescent population (Germany [63]). All surveys used stratified random sampling methods to select a study sample that represented the national population.…”