Evidence map›Paper›PMID 23834883›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2013

Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions.

Raymond Oppong, Mark Jit, Richard D Smith, Christopher C Butler, Hasse Melbye, Sigvard Mölstad, Joanna Coast

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Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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  8. The impact of acute pneumococcal disease on health state utility values: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Raymond OppongHealth Economics Unit, School of Health and Population Sciences, University of Birmingham, Birmingham. r.a.oppong@bham.ac.uk
Mark Jit
Richard D Smith
Christopher C Butler
Hasse Melbye
Sigvard Mölstad
Joanna Coast

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoint-of-care C-reactive protein (POCCRP) is a biomarker of inflammation that offers clinicians a rapid POC test to guide antibiotic prescribing decisions for acute cough and lower respiratory tract infections (LRTI). However, evidence that POCCRP is cost-effective is limited, particularly outside experimental settings.

aimTo assess the cost-effectiveness of POCCRP as a diagnostic tool for acute cough and LRTI from the perspective of the health service. DESIGN AND

settingObservational study of the presentation, management, and outcomes of patients with acute cough and LRTI in primary care settings in Norway and Sweden.

methodUsing hierarchical regression, data were analysed in terms of the effect on antibiotic use, cost, and patient outcomes (symptom severity after 7 and 14 days, time to recovery, and EQ-5D), while controlling for patient characteristics (self-reported symptom severity, comorbidities, and health-related quality of life) at first attendance.

resultsPOCCRP testing is associated with non-significant positive reductions in antibiotic prescribing (P = 0.078) and increased cost (P = 0.092). Despite the uncertainty, POCCRP testing is also associated with a cost per quality-adjusted life year (QALY) gain of €9391. At a willingness-to-pay threshold of €30,000 per QALY gained, there is a 70% probability of CRP being cost-effective.

conclusionPOCCRP testing is likely to provide a cost-effective diagnostic intervention both in terms of reducing antibiotic prescribing and in terms of QALYs gained.

Indexed as

C-Reactive ProteinPoint-of-Care SystemsPractice Patterns, Physicians'Primary Health CareAdolescentAdultAgedAged, 80 and overAnti-Bacterial AgentsAttitude of Health PersonnelBiomarkersCost-Benefit AnalysisDecision MakingFemaleHumansMaleAnti-Bacterial AgentsBiomarkersC-Reactive Protein

Identifiers

PMID23834883
PMCPMC3693803

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.