Evaluación económica de estrategias de prueba combinadas utilizando las pruebas de velocidad de eritrosedimentación y...

To conduct an economic analysis of the use of combined ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein) testing strategies compared to CRP testing alone in U.S hospitals.

A decision tree model was developed to evaluate the cost-effectiveness and cost-benefit of combined ESR and CRP testing compared to CRP alone. The model estimated the laboratory costs, number of misdiagnoses, and follow-up costs associated with misdiagnoses. Model inputs were sourced from published literature and clinical guidelines. Two combined testing strategies were evaluated: 1) result is positive only if both ESR and CRP results are positive (ESR + CRP) and 2) result is positive if either the ESR or CRP result is positive (ESR/CRP). Strategies were evaluated for five individual and three grouped conditions.

Results demonstrated that the ESR + CRP testing strategy is a cost-effective strategy for reducing misdiagnoses and is expected to result in a net cost reduction to the healthcare system when accounting for the reduction in follow-up costs associated with misdiagnoses. In contrast, the ESR/CRP strategy led to increased misdiagnoses when compared to CRP alone.

Results indicate that adopting the ESR + CRP strategy would reduce misdiagnoses and overall costs to healthcare systems.