ArticlePloS one2013
Rapid molecular testing for TB to guide respiratory isolation in the U.S.: a cost-benefit analysis.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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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
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cost-effectiveness of GeneXpert and LED-FM for diagnosis of pulmonary tuberculosis: A systematic review.PloS one · 2018Pooled it
- Second Time's the Charm? Assessing the Sensitivity and Yield of Inpatient Diagnostic Algorithms for Pulmonary Tuberculosis in a Low-Prevalence Setting.Open forum infectious diseases · 2024Article
- Evolution of Laboratory Diagnosis of Tuberculosis.Clinics and practice · 2024Review
- Comparing the cost-effectiveness of the MPT64-antigen detection test to Xpert MTB/RIF and ZN-microscopy for the diagnosis of Extrapulmonary Tuberculosis: An economic evaluation modelling study.PLOS global public health · 2024Article
- Article
- Use of Nucleic Acid Amplification Testing for Rapid Detection ofOpen forum infectious diseases · 2021Article
- Isolation and deisolation of patients admitted with presumptive pulmonary tuberculosis. Can it be shortened?Saudi medical journal · 2019Article
- Association of Rapid Molecular Testing With Duration of Respiratory Isolation for Patients With Possible Tuberculosis in a US Hospital.JAMA internal medicine · 2018Article
- Practical Guidance for Clinical Microbiology Laboratories: Mycobacteria.Clinical microbiology reviews · 2018Review
- Clinical Impact and Cost-effectiveness of Xpert MTB/RIF Testing in Hospitalized Patients With Presumptive Pulmonary Tuberculosis in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Issues Related to the Updated 2014 Korean Guidelines for Tuberculosis.Tuberculosis and respiratory diseases · 2016Review
- Sample-to-result molecular infectious disease assays: clinical implications, limitations and potential.Expert review of molecular diagnostics · 2016Review
- Evaluation of the Cepheid Xpert MTB/RIF assay.Expert review of molecular diagnostics · 2015Review
- Impact of GeneXpert MTB/RIF assay on triage of respiratory isolation rooms for inpatients with presumed tuberculosis: a hypothetical trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Article
- Performance evaluation of the Xpert MTB/RIF assay according to its clinical application.BMC infectious diseases · 2014Article
- Emerging technologies for the clinical microbiology laboratory.Clinical microbiology reviews · 2014Review
- Article
- How we can utilize the Xpert MTB/RIF assay to decide on airborne infection isolation of inpatients with tuberculosis suspicion in Brazil: a brief review of the current data.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundRespiratory isolation of inpatients during evaluation for TB is a slow and costly process in low-burden settings. Xpert MTB/RIF (Xpert) is a novel molecular test for tuberculosis (TB) that is faster and more sensitive but substantially more expensive than smear microscopy. No previous studies have examined the costs of molecular testing as a replacement for smear microscopy in this setting.
methodsWe conducted an incremental cost-benefit analysis comparing the use of a single negative Xpert versus two negative sputum smears to release consecutive adult inpatients with presumed TB from respiratory isolation at an urban public hospital in the United States. We estimated all health-system costs and patient outcomes related to Xpert implementation, diagnostic evaluation, isolation, hospitalization, and treatment. We performed sensitivity and probabilistic uncertainty analyses to determine at what threshold the Xpert strategy would become cost-saving.
resultsAmong a hypothetical cohort of 234 individuals undergoing evaluation for presumed active TB annually, 6.4% had culture-positive TB. Compared to smear microscopy, Xpert reduced isolation bed utilization from an average of 2.7 to 1.4 days per patient, leading to a 48% reduction in total annual isolation bed usage from 632 to 328 bed-days. Xpert saved an average of $2,278 (95% uncertainty range $1582-4570) per admission, or $533,520 per year, compared with smear microscopy.
conclusionsMolecular testing for TB could provide substantial savings to hospitals in high-income countries by reducing respiratory isolation usage and overall length of stay.
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