PDF(Pubmed)
Abstract：
Combination COVID-19/influenza rapid tests provide a way to quickly and accurately differentiate between the two infections. The goal of this economic evaluation was to assess the cost and health benefits of a combination COVID-19/influenza Rapid Diagnostic Test (RDT) vs. current standard-of-care in the Brazilian private healthcare setting. A dual decision tree model was developed to estimate the impact of rapid differentiation of COVID-19 and influenza in a hypothetical cohort of 1,000 adults with influenza-like illness in an ambulatory healthcare setting. The model compared the use of a combination COVID-19/influenza RDT to Brazil standard diagnostic practice of a COVID-19 RDT and presumptive influenza diagnosis. Different levels of influenza prevalence were modeled with co-infection estimated as a function of the COVID-19 prevalence. Outcomes included accuracy of diagnosis, antiviral prescriptions and healthcare resource use (hospital bed days and ICU occupancy). Depending on influenza prevalence, considering 1,000 patients with influenza-like illness, a combination RDT compared to standard practice was estimated to result in between 88 and 149 fewer missed diagnoses of influenza (including co-infection), 161 to 185 fewer cases of over-diagnosis of influenza; a 24 to 34% reduction in hospital bed days and a 16 to 26% reduction in ICU days. In the base case scenario (20% influenza, 5% COVID-19), the combination RDT was estimated to result in cohort cost savings of $99. Based upon a de novo economic model, this analysis indicates that use of a combination RDT could positively impact influenza antiviral prescriptions and lower healthcare resource use.
摘要：
COVID-19/流感组合快速检测提供了一种快速准确区分两种感染的方法。这项经济评估的目标是评估COVID-19/流感快速诊断测试(RDT)与组合的成本和健康效益。巴西私人医疗保健环境中的当前护理标准。开发了一个双决策树模型，以估计COVID-19和流感的快速分化对门诊医疗机构中1000名患有流感样疾病的成年人的假设队列的影响。该模型比较了COVID-19/流感RDT组合的使用与巴西标准的COVID-19RDT诊断实践和推定流感诊断。不同水平的流感流行率被建模，共感染估计为COVID-19流行率的函数。结果包括诊断的准确性，抗病毒处方和医疗资源使用(病床天数和ICU入住)。根据流感流行情况，考虑到1000名患有流感样疾病的患者，与标准做法相比，RDT组合估计可减少88至149例流感（包括合并感染）的漏诊，流感过度诊断病例减少161至185例；医院病床天数减少24%至34%，ICU天数减少16%至26%。在基本情况下(20%流感，5%COVID-19），RDT组合估计可节省队列成本99美元.基于从头经济模型，这项分析表明,联合使用RDT可能会对流感抗病毒处方产生积极影响,并降低医疗保健资源的使用.
