10516788

Source:http://linkedlifedata.com/resource/pubmed/id/10516788

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Predicate	Object
rdf:type	pubmed:Citation
lifeskim:mentions	umls-concept:C0010181, umls-concept:C0023290, umls-concept:C0679199
pubmed:issue	8
pubmed:dateCreated	1999-10-21
pubmed:abstractText	Reported are the results of a formal decision analysis which facilitated the choice of the most appropriate test-treatment strategy for visceral leishmaniasis in areas where the disease is endemic. The following strategies were compared: treatment of all suspects (strategy A); testing by means of parasitological investigation followed by treatment of positives (strategy B); two-step testing by means of the direct agglutination test (DAT) followed by treatment of patients with high titres as well as those with parasitologically confirmed borderline titres (strategy C); and DAT followed by treatment of positives (strategy D). The results for each strategy were expressed as costs in US$ per death averted. The effectiveness of strategies C and D was close to that of strategy A and far better than that of strategy B. The cost-effectiveness ratio for strategies C and D (US$ 465 per death averted) was not substantially higher than that of testing by means of parasitological investigation followed by treatment of positives (strategy B), which was the most cost-effective strategy at US$448 per death averted. At current prices of antimonial drugs, the cost of test-treatment strategies depends more on the cost of treatment than on that of testing. The use of a sensitive serological test such as the DAT is recommended as the basis of test-treatment strategies for visceral leishmaniasis in areas where the disease is endemic.
pubmed:keyword	http://linkedlifedata.com/resource/pubmed/keyword/Cost Effectiveness, http://linkedlifedata.com/resource/pubmed/keyword/Diseases, http://linkedlifedata.com/resource/pubmed/keyword/Evaluation, http://linkedlifedata.com/resource/pubmed/keyword/Evaluation Indexes, http://linkedlifedata.com/resource/pubmed/keyword/Examinations And Diagnoses, http://linkedlifedata.com/resource/pubmed/keyword/LEISHMANIASIS, http://linkedlifedata.com/resource/pubmed/keyword/Laboratory Examinations And Diagnoses, http://linkedlifedata.com/resource/pubmed/keyword/Mathematical Model, http://linkedlifedata.com/resource/pubmed/keyword/Models, Theoretical, http://linkedlifedata.com/resource/pubmed/keyword/PARASITIC DISEASES, http://linkedlifedata.com/resource/pubmed/keyword/Quantitative Evaluation, http://linkedlifedata.com/resource/pubmed/keyword/Research Methodology, http://linkedlifedata.com/resource/pubmed/keyword/Summary Report, http://linkedlifedata.com/resource/pubmed/keyword/Treatment
pubmed:language	eng
pubmed:journal	http://linkedlifedata.com/resource/pubmed/journal/7507052
pubmed:citationSubset	IM
pubmed:status	MEDLINE
pubmed:issn	0042-9686
pubmed:author	pubmed-author:BoelaertMM, pubmed-author:DesjeuxPP, pubmed-author:LynenLL, pubmed-author:Van der StuyftPP
pubmed:issnType	Print
pubmed:volume	77
pubmed:owner	NLM
pubmed:authorsComplete	Y
pubmed:pagination	667-74
pubmed:dateRevised	2009-5-29
pubmed:otherAbstract	PIP: This paper reports the results of a formal decision analysis. This facilitates in choosing the most appropriate test-treatment strategy for visceral leishmaniasis in endemic areas. Four strategies were compared based on their cost-effectiveness expressed in US dollars per death averted. These strategies include: (A) testing by means of parasitological investigation followed by treatment of positives; (B) two-step testing by means of the direct agglutination test (DAT); (C) treatment of patients with high titers as well as those with parasitologically confirmed borderline titers; and (D) DAT followed by treatment of positives. The results showed that the effectiveness of strategies C and D was close to that of strategy A and far better than that of strategy B. The cost-effectiveness ratio for strategies C and D was US$465 per death averted, which is not substantially higher than that of strategy B, while strategy B is the most cost-effective at US$448 per death averted.
pubmed:meshHeading	pubmed-meshheading:10516788-Agglutination Tests, pubmed-meshheading:10516788-Cost-Benefit Analysis, pubmed-meshheading:10516788-Costs and Cost Analysis, pubmed-meshheading:10516788-Humans, pubmed-meshheading:10516788-Leishmaniasis, Visceral, pubmed-meshheading:10516788-Sensitivity and Specificity
pubmed:year	1999
pubmed:articleTitle	Cost-effectiveness of competing diagnostic-therapeutic strategies for visceral leishmaniasis.
pubmed:affiliation	Unit of Epidemiology, Institute of Tropical Medicine, Antwerp, Belgium.
pubmed:publicationType	Journal Article, Comparative Study, Research Support, Non-U.S. Gov't