将埃博拉预测得分工具和快速诊断测试纳入查算法的成本效益:一个决策分析模型
Antoine Oloma Tshomba1,2, Daniel Mukadi-Bamuleka2,3, Anja De Weggheleire4
1Department of Public Health, University of Kisangani, Kisangani, Democratic Republic of Congo (DRC).
PloS one
|October 17, 2023
概括
这项研究发现,将埃博拉预测得分 (ECPS) 与快速诊断测试 (RDT) 结合起来,提供了最具成本效益的埃博拉病毒病 (EVD) 查. 建议使用QuickNaviTM-Ebola RDT的双ECPS条件测试,以在疫情期间有效检测EVD.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 埃博拉病毒病 (EVD) 缺乏明显的临床症状,需要改进的查工具.
- 目前针对埃博拉病毒的查方法需要证明临床益处和经济效率.
- 没有确立的算法或证据可用于最佳的EVD查.
研究的目的:
- 评估将埃博拉预测得分和快速诊断测试整合到EVD查算法中的医疗保健效率.
- 在疫情爆发期间确定最具成本效益的埃博拉病毒查策略.
主要方法:
- 收集了 RDT 和预测分数的准确性数据 (灵敏度,特异性).
- 每个疑似患者的病例管理,RDT查和医疗保健服务的计算成本.
- 开发了一个分析决策模型来评估八种查策略,包括世卫组织病例定义,ECPS变异和RDT组合.
- 进行了成本效益分析和灵敏度分析,以确定最佳算法.
主要成果:
- 双重ECPS作为条件测试与QuickNaviTM-Ebola RDT相结合是最具成本效益的查算法 (0.86效率,每名患者106.7美元).
- 其他有效的策略包括ECPS作为条件测试 (0.80有效率,111.5美元/患者) 和ECPS作为与RDT联合测试 (0.81有效率,131.5美元/患者).
- 结果对埃博拉病毒流行率和RDT敏感性敏感.
结论:
- 预测得分和RDTs可以显著提高埃博拉查效率.
- 建议使用ECPS条件测试和使用RDT算法的双ECPS条件测试,以减少EBD流行期间的确认测试和总体成本.
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