Source:http://linkedlifedata.com/resource/pubmed/id/17147006
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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
4
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pubmed:dateCreated |
2006-12-6
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pubmed:abstractText |
The objective was to assess the cost-effectiveness of population screening for alpha-1 antitrypsin (AAT) deficiency. The design was a Markov-based decision analytic model. Hypothetical cohorts were analyzed from birth and followed over time until death using Monte Carlo simulation. The following strategies were compared: 1) screen all newborns, 2) screen all 10-year-old children, and 3) do not screen. Screenees found to have PI*ZZ AAT deficiency received the benefits of lower smoking rates and were offered augmentation therapy. In keeping with reported experience, most (96%) non-screened AAT deficient individuals remained undiagnosed and, therefore, missed these benefits. Under base conditions, screening all newborns cost nearly $422,000 per quality-adjusted life-year (QALY) gained; this estimate fell to $92,135 per QALY when the cost of screening was minimized to $6 in the model. Delaying screening until age 10 decreased the incremental cost-effectiveness ratio (ICER) to nearly $317,000. In sensitivity analysis, when the prevalence of PI*ZZ individuals increased from a baseline of 1.96 to 16 per 10,000, the ICER for newborn screening decreased below $100,000 per QALY. When the cost of screening and augmentation therapy were decreased simultaneously with increasing PI*ZZ prevalence, there were many scenarios in which the ICER decreased below $50,000. While population-based screening for AAT deficiency is not cost-effective under current conditions, cost-effectiveness criteria could be satisfied when case-finding in a high prevalence population is undertaken.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:month |
Dec
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pubmed:issn |
1541-2555
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
2
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
411-8
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pubmed:dateRevised |
2009-11-17
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pubmed:meshHeading |
pubmed-meshheading:17147006-Cost-Benefit Analysis,
pubmed-meshheading:17147006-Decision Support Techniques,
pubmed-meshheading:17147006-Humans,
pubmed-meshheading:17147006-Markov Chains,
pubmed-meshheading:17147006-Mass Screening,
pubmed-meshheading:17147006-Monte Carlo Method,
pubmed-meshheading:17147006-Phenotype,
pubmed-meshheading:17147006-Quality of Life,
pubmed-meshheading:17147006-Quality-Adjusted Life Years,
pubmed-meshheading:17147006-United States,
pubmed-meshheading:17147006-alpha 1-Antitrypsin Deficiency
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pubmed:year |
2005
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pubmed:articleTitle |
Cost-effectiveness of population screening for alpha-1 antitrypsin deficiency: a decision analysis.
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pubmed:affiliation |
Center for Pharmaceutical Outcomes and Policy, The Johns Hopkins Hospital, Cleveland, Ohio, USA.
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pubmed:publicationType |
Journal Article
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