ArticlePloS one2012
A cost-effectiveness analysis of "test" versus "treat" patients hospitalized with suspected influenza in Hong Kong.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review.PharmacoEconomics · 2021Pooled it
- Cost-Effectiveness of Antiviral Treatments for Pandemics and Outbreaks of Respiratory Illnesses, Including COVID-19: A Systematic Review of Published Economic Evaluations.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2020Pooled it
- Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer.PharmacoEconomics · 2016Pooled it
- Economic evaluations of interventions against viral pandemics: a scoping review.Public health · 2022Article
- Costs and benefits of interventions aimed at major infectious disease threats: lessons from the literature.The European journal of health economics : HEPAC : health economics in prevention and care · 2020Review
- Utility of Rapid Influenza Molecular Testing in an Outpatient Hemodialysis Unit: A Prospective Cohort Study.Canadian journal of kidney health and disease · 2020Article
- A three-year survey of the antimicrobial resistance of microorganisms at a Chinese hospital.Experimental and therapeutic medicine · 2016Article
- Article
- Respiratory Viral Testing and Influenza Antiviral Prescriptions During Hospitalization for Acute Respiratory Illnesses.Open forum infectious diseases · 2016Article
- An algorithm to diagnose influenza infection: evaluating the clinical importance and impact on hospital costs of screening with rapid antigen detection tests.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2015Article
- Article
- Article
- Report of the first Asia-Pacific Forum on antiviral treatment of influenza, Asia-Pacific Alliance for the Control of Influenza, Bangkok, 14 June 2012.Influenza and other respiratory viruses · 2013Article
- The epidemiological and public health research response to 2009 pandemic influenza A(H1N1): experiences from Hong Kong.Influenza and other respiratory viruses · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeasonal and 2009 H1N1 influenza viruses may cause severe diseases and result in excess hospitalization and mortality in the older and younger adults, respectively. Early antiviral treatment may improve clinical outcomes. We examined potential outcomes and costs of test-guided versus empirical treatment in patients hospitalized for suspected influenza in Hong Kong.
methodsWe designed a decision tree to simulate potential outcomes of four management strategies in adults hospitalized for severe respiratory infection suspected of influenza: "immunofluorescence-assay" (IFA) or "polymerase-chain-reaction" (PCR)-guided oseltamivir treatment, "empirical treatment plus PCR" and "empirical treatment alone". Model inputs were derived from literature. The average prevalence (11%) of influenza in 2010-2011 (58% being 2009 H1N1) among cases of respiratory infections was used in the base-case analysis. Primary outcome simulated was cost per quality-adjusted life-year (QALY) expected (ICER) from the Hong Kong healthcare providers' perspective.
resultsIn base-case analysis, "empirical treatment alone" was shown to be the most cost-effective strategy and dominated the other three options. Sensitivity analyses showed that "PCR-guided treatment" would dominate "empirical treatment alone" when the daily cost of oseltamivir exceeded USD18, or when influenza prevalence was <2.5% and the predominant circulating viruses were not 2009 H1N1. Using USD50,000 as the threshold of willingness-to-pay, "empirical treatment alone" and "PCR-guided treatment" were cost-effective 97% and 3% of time, respectively, in 10,000 Monte-Carlo simulations.
conclusionsDuring influenza epidemics, empirical antiviral treatment appears to be a cost-effective strategy in managing patients hospitalized with severe respiratory infection suspected of influenza, from the perspective of healthcare providers in Hong Kong.
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