Economic evaluation of laboratory diagnostic test types in Covid-19 epidemic: A systematic review

Dolatshahi, Zeinab; Nargesi, Shahin; Sadeghifar, Jamil; Mezginejad, Fateme; Jafari, Abdosaleh; Bazyar, Mohammad; Ghafourian, Sobhan; Saniee, Nadia

doi:10.1016/j.ijsu.2022.106820

Cited by 7 publications

(6 citation statements)

References 37 publications

(85 reference statements)

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“…Many studies have examined the cost-effectiveness of various test strategies for SARS-CoV-2, but studies focusing on universal admission screening are limited. 23 – 25 Stevenson et al 24 modeled 30 SARS-CoV-2 test strategies for patients admitted from the emergency department, with a community prevalence of 5.3%. These researchers found that the least costly test strategy was testing on hospital admission with retesting 6 days after admission, and they recommended that using tests with shorter turnaround times would be more cost-effective.…”

Section: Discussionmentioning

confidence: 99%

“…Factors such as dominant virus variants in circulation, lack of appropriate vaccinations and pharmaceuticals, and the surge in the number of patients requiring care from the healthcare system should also be considered to justify universal admission screening during the early period of the COVID-19 pandemic. 3 , 6 , 16 , 17 , 23 As the pandemic evolved, the virulence of the variants changed, effective vaccinations and antiviral agents were developed, and the immunity of the population increased. 16 , 21 , 26 , 27 Therefore, the extra benefits of universal admission screening added to the existing hierarchy of IPC measures (eg, the appropriate use of PPEs, active health surveillance of healthcare workers, optimal unit layouts with enhanced ventilation) might need to be re-evaluated.…”

Section: Discussionmentioning

confidence: 99%

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Coronavirus disease 2019 (COVID-19) universal admission screening in patients and companions in Taiwan from May 2021 to June 2022: A nationwide multicenter study

Wu¹,

Su²,

Chien³

et al. 2023

Infect. Control Hosp. Epidemiol.

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Objective: Universal admission screening and follow-up symptom-based testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play critical roles in controlling nosocomial transmission. We describe the performance of test strategies for inpatients and their companions during various disease incidences in Taiwan. Design: Retrospective population-based cohort study. Setting: The study was conducted across 476 hospitals in Taiwan. Methods: The data for both testing strategies by reverse transcription-polymerase chain reaction for SARS-CoV-2 in newly admitted patients and their companions during May 2021—June 2022 were extracted and analyzed. Results: The positivity rate of universal admission screening was 0.76% (14,640 of 1,928,676) for patients and 0.37% (5,372 of 1,438,944) for companions. The weekly community incidences of period 1 (May 2021–June 2021), period 2 (July 2021–March 2022), and period 3 (April 2022–June 2022) were 6.57, 0.27, and 1,261, respectively, per 100,000 population. The positivity rates of universal admission screening for patients and companions (4.39% and 2.18%) in period 3 were higher than those in periods 1 (0.29% and 0.04%) and 2 (0.03% and 0.003%) (all P < .01). Among the 22,201 confirmed cases, 9.86% were identified by symptom-based testing. The costs and potential savings of universal admission screening for patients and companions achieved a breakeven point when the test strategy was implemented in a period with weekly community incidences of 27 and 358 per 100,000 population, respectively. Conclusions: Universal admission screening and follow-up symptom-based testing is important for reducing nosocomial transmission. Implementing universal admission screening at an appropriate time would balance the benefits with costs and potential unintended harms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) universal admission screening in patients and companions in Taiwan from May 2021 to June 2022: A nationwide multicenter study

Wu¹,

Su²,

Chien³

et al. 2023

Infect. Control Hosp. Epidemiol.

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“…A decision on any disagreement was assigned and affirmed by a third arbitrator. Items that fully met the checklist in the selected studies were scored “1” and addressed as “Y.” Partially concordant cases received a score of “0.5” and were designated as “P,” and no concordant cases received a “zero” score and were designated as “N.” The high quality studies constituted >85% followed by very good quality <70%–85%, good <55%–70%, and low quality studies <55% 29,30 …”

Section: Methodsmentioning

confidence: 99%

“…Partially concordant cases received a score of "0.5" and were designated as "P," and no concordant cases received a "zero" score and were designated as "N." The high quality studies constituted >85% followed by very good quality <70%-85%, good <55%-70%, and low quality studies <55%. 29,30 3 | RESULTS…”

Section: Quality Assessmentmentioning

confidence: 99%

Economic evaluation of vaccination against COVID‐19: A systematic review

Zeinab,

Shahin,

Fateme

et al. 2024

Health Science Reports

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Background and AimsCoronavirus has burdened considerable expenditures on the different health systems. Vaccination programs, the critical solution against pandemic diseases, are known as safe and effective interventions to prevent and control epidemics. We aimed to perform a systematic review to provide economic evidence of the value of different types of vaccines available to combat the Covid‐19 to all health policymakers worldwide.MethodsElectronic searches conducted on Medline/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and other economic evaluation databases. Related and published articles searched up to March 2022 by using keywords such as “Vaccination,” “Covid‐19,” “Cost‐benefit,” “Cost‐utility,” “Cost‐effectiveness,” “Economic Assessment,” and “Economic evaluation.” Followed by choosing the most suitable articles according to inclusion and exclusion criteria, data captured and the results extracted. The quality assessment of the articles performed by the checklist of CHEERS 2022. Finally, 13 articles included in the review.ResultsAll messenger RNA vaccines were dominant with approximately 70% coverage against no vaccination in the primary vaccination program except in one study that looked at booster effects. From a payer's perspective, a dollar invested in a vaccine would be less profitable than from a societal perspective. Therefore, primary mass vaccination can be considered a cost‐effective intervention in primary vaccination to save more lives and produce more positive externalities. However, the cost‐benefit ratio for all vaccines increases when statistical lifetime value and global economic and educational disadvantages are considered.ConclusionThe COVID‐19 primary vaccination programs in regional outbreaks, from a long‐term perspective, will demonstrate substantial cost‐effectiveness. It is suggested that due to the positive externalities of vaccination, primary mass vaccination, with the help of COVAX‐19TM, could be considered a reliable way to combat viral epidemics compared to the loss of individual lives and economic and educational disturbances around the world.

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“…Real-time RT-PCR is the current reference laboratory test, considered the “ gold standard ” for its high sensitivity and specificity [26]. However, despite the high diagnostic accuracy, the high cost, the need for ribonucleic acid (RNA) extraction, the availability of specialized raw materials, and the relatively long execution time, makes it is difficult to be applied on a large scale [27,28]. On the other side, serological tests are reliable, simple, and inexpensive techniques that allow direct and indirect detection of infections; however, they detect the presence of antibodies as a marker of past infection [29].…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis comparing the diagnostic accuracy tests of COVID-19

Vilca-Alosilla

Candia-Puma

Coronel-Monje

et al. 2022

Preprint

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In this work, we report a systematic review and meta-analysis that seeks to analyze the accuracy of diagnostic tests for coronavirus disease 2019 (COVID-19). The objective of this article is to detail the scientific findings based on diagnostic tests of the last years when the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred. Searches for published studies were carried out in the PubMed database between the years 2020 and 2021 for the diagnosis of COVID-19. Ninety-nine scientific articles that met the criteria were examined and accepted in the meta-analysis, and the diagnostic accuracy was evaluated through specificity and sensitivity. Molecular tests [Reverse transcription polymerase chain reaction (RT-PCR), reverse transcription loop-mediated isothermal amplification (RT-LAMP), and clustered regularly interspaced short palindromic repeats (CRISPR)] showed better performance in terms of sensitivity and specificity when compared to serological tests [Enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay (CLIA), lateral flow immunoassay (LFIA), chemiluminescent microparticle immunoassays (CMIA), and Fluorescence immunoassay (FIA)], which showed higher specificity, mainly for the detection of IgG antibodies; however, they showed sensitivity <90%. In addition, the antiviral neutralization bioassay (ANB) diagnostic test demonstrated high potential for the diagnosis of COVID-19, since it obtained the highest area under the curve restricted to the false-positive rates (AUCFPR) of 0.984. It is settled that the different diagnostic tests have been efficiently adapted for the detection of SARS-CoV-2; however, their performance still needs to be optimized to control future outbreaks of COVID-19, which will also serve to help the control of future infectious agents.

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Economic evaluation of laboratory diagnostic test types in Covid-19 epidemic: A systematic review

Cited by 7 publications

References 37 publications

Coronavirus disease 2019 (COVID-19) universal admission screening in patients and companions in Taiwan from May 2021 to June 2022: A nationwide multicenter study

Coronavirus disease 2019 (COVID-19) universal admission screening in patients and companions in Taiwan from May 2021 to June 2022: A nationwide multicenter study

Economic evaluation of vaccination against COVID‐19: A systematic review

A systematic review and meta-analysis comparing the diagnostic accuracy tests of COVID-19

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