Evidence map›Paper›PMID 26260835›Full record

ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2015

Cost-effectiveness of improvements in diagnosis and treatment accessibility for tuberculosis control in India.

S-C Suen, E Bendavid, J D Goldhaber-Fiebert

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 5 pooled it
2.1field-weighted citation impact, top 12% of its field
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

21 citing papers in PubMed, 5 syntheses or guidelines pooled it, 34 citations in OpenAlex.

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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

3 authors at 1 institution in 1 country.

S-C SuenDepartment of Management Science and Engineering, Stanford University, Stanford, California, USA.
E BendavidDivision of General Medical Disciplines, Department of Medicine, Stanford University, Stanford, California, USA; Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, California, USA.
J D Goldhaber-FiebertCenter for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, California, USA.
Stanford University · US

Funding

Making Better Decisions: Policy Modeling for AIDS and Drug AbuseR01DA015612 · NIDA · STANFORD UNIVERSITY · PI OWENS, DOUGLAS K · 2002 to 2017
$9.4M
Making Better Decisions: Policy Modeling for AIDS and Drug AbuseR37DA015612 · NIDA · STANFORD UNIVERSITY · PI DOUGLAS K OWENS · 2019 to 2026
$6.3M
Improving the Public Health Impact of HIV Testing in Highly Endemic RegionsK01AI084582 · NIAID · STANFORD UNIVERSITY · PI BENDAVID, ERAN · 2009 to 2013
$652k
Cost-effective chronic disease prevention in developing countriesK01AG037593 · NIA · STANFORD UNIVERSITY · PI GOLDHABER-FIEBERT, JEREMY DAVID · 2011 to 2015
$637k
NIAID NIH HHS K01 AI084582NIAID NIH HHS K01-AI084582NIA NIH HHS K01 AG037593NIA NIH HHS K01-AG037593-01A1NIDA NIH HHS R01 DA015612NIDA NIH HHS R01-DA15612NIDA NIH HHS R37 DA015612
6 · The paper itself

Abstract

settingInaccurate diagnosis and inaccessibility of care undercut the effectiveness of high-quality anti-tuberculosis treatment and select for resistance. Rapid diagnostic systems, such as Xpert(®) MTB/RIF for tuberculosis (TB) diagnosis and drug susceptibility testing (DST), and programs that provide high-quality DOTS anti-tuberculosis treatment to patients in the unregulated private sector (public-private mix [PPM]), may help address these challenges, albeit at increased cost. OBJECTIVE/

designWe extended a microsimulation model of TB in India calibrated to demographic, epidemiologic, and care trends to evaluate 1) replacing DST with Xpert; 2) replacing microscopy and culture with Xpert to diagnose multidrug-resistant TB (MDR-TB) and non-MDR-TB; 3) implementing nationwide PPM; and combinations of (3) with (1) or (2).

resultsPPM (assuming costs of $38/person) and Xpert improved health and increase costs relative to the status quo. PPM alone or with Xpert cost <1 gross domestic product/capita per quality-adjusted life-year gained relative to the next best intervention, and dominated Xpert interventions excluding PPM.

conclusionsWhile both PPM and Xpert are promising tools for combatting TB in India, PPM should be prioritized over Xpert, as private sector engagement is more cost-effective than Xpert alone and, if sufficient resources are available, would substantially increase the value of Xpert if both interventions are implemented together.

Indexed as

AdolescentAdultAgedAged, 80 and overChildChild, PreschoolCost-Benefit AnalysisDiagnostic Tests, RoutineFemaleHumansIndiaInfantInfant, NewbornMaleMiddle AgedModels, Theoretical

Identifiers

PMID26260835
PMCPMC5927581
OpenAlexW2418729976

What OpenQuestion holds

Textmetadata
LicenceTDM
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.