Comparative effectiveness of a rapid point-of-care test for detection of Chlamydia trachomatis among women in a clinical setting
Clinical & Population Health Research Program
Center for Outcomes Research; Department of Pediatrics
Medical Subject Headings
Sexually Transmitted Diseases, Bacterial; Chlamydia Infections; Mass Screening; Point-of-Care Systems; Cost-Benefit Analysis
Bacterial Infections and Mycoses | Health Services Research | Life Sciences | Medicine and Health Sciences | Obstetrics and Gynecology | Pediatrics | Preventative Medicine
OBJECTIVES: To compare the effectiveness and cost-effectiveness of a promising new point-of-care (POC) chlamydia test with traditional nucleic acid amplification testing (NAAT), and to determine the characteristics that would make a POC test most cost-effective.
METHODS: A decision tree was constructed to model chlamydia screening visits to a sexually transmitted disease clinic by a hypothetical cohort of 10 000 women. The model incorporated programmatic screening costs, treatment costs and medical costs averted through prevention of pelvic inflammatory disease (PID) and its sequelae. Parameter values and costs were estimated for each node in the decision tree based on primary data, published data and unpublished health data.
For the base-case scenario (POC sensitivity 92.9%; 47.5% of women willing to wait 40 min for test results; test cost $33.48), POC was estimated to save US$5050 for each case of PID averted compared with NAAT. One-way sensitivity analyses indicated that POC would dominate NAAT if the POC test cost is
A promising new chlamydia POC test is likely to be cost-effective compared with traditional NAAT. The POC test sensitivity, cost and proportion of women willing to wait for the POC test result are key elements to determining the cost-effectiveness of any new POC test strategy.
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Citation: Sex Transm Infect. 2012 Sep 14. [Epub ahead of print] doi:10.1136/sextrans-2011-050355