Economic Evaluation of Combined Testing Strategies Using Erythrocyte Sedimentation Rate and C-Reactive Protein Tests

Area of Science:

• Medical Diagnostics
• Health Economics
• Clinical Laboratory Science

Background:

• Inflammatory markers like Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) are crucial in diagnosing various conditions.
• Current diagnostic strategies often rely on C-Reactive Protein (CRP) testing alone.
• The economic implications and diagnostic accuracy of combined ESR and CRP testing strategies require thorough evaluation.

Purpose of the Study:

• To perform an economic analysis comparing combined ESR and CRP testing strategies against CRP testing alone in US hospitals.
• To evaluate the cost-effectiveness and cost-benefit of different combined testing approaches.

Main Methods:

• A decision tree model was developed to assess cost-effectiveness and cost-benefit.
• The model incorporated laboratory costs, misdiagnosis rates, and follow-up expenses.
• Two combined strategies were analyzed: ESR + CRP (both positive) and ESR/CRP (either positive) across multiple conditions.

Main Results:

• The ESR + CRP strategy proved cost-effective, significantly reducing misdiagnoses.
• This strategy is projected to yield net cost savings for the healthcare system by lowering follow-up costs.
• Conversely, the ESR/CRP strategy resulted in higher misdiagnosis rates compared to CRP alone.

Conclusions:

• Implementing the ESR + CRP testing strategy can decrease misdiagnoses.
• Adoption of the ESR + CRP approach is expected to lower overall healthcare system expenditures.