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Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments

BACKGROUND: Tétanos Quick Stick® (TQS) is a test for tetanus immunity screening for wounded patients in emergency departments (EDs), but represents additional costs compared with a medical interview on vaccination history. The study objective was to assess the effectiveness and cost of the TQS in Fr...

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Autores principales: N'Diaye, Dieynaba S, Schwarzinger, Michaël, Obach, Dorothée, Poissy, Julien, Matheron, Sophie, Casalino, Enrique, Yazdanpanah, Yazdan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4246690/
https://www.ncbi.nlm.nih.gov/pubmed/25407690
http://dx.doi.org/10.1186/s12879-014-0603-3
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author N'Diaye, Dieynaba S
Schwarzinger, Michaël
Obach, Dorothée
Poissy, Julien
Matheron, Sophie
Casalino, Enrique
Yazdanpanah, Yazdan
author_facet N'Diaye, Dieynaba S
Schwarzinger, Michaël
Obach, Dorothée
Poissy, Julien
Matheron, Sophie
Casalino, Enrique
Yazdanpanah, Yazdan
author_sort N'Diaye, Dieynaba S
collection PubMed
description BACKGROUND: Tétanos Quick Stick® (TQS) is a test for tetanus immunity screening for wounded patients in emergency departments (EDs), but represents additional costs compared with a medical interview on vaccination history. The study objective was to assess the effectiveness and cost of the TQS in French EDs. METHODS: We performed a model-based analysis that simulates screening of tetanus immunity and risk of tetanus based on prophylaxis administration. Strategies compared were: i) diagnosis of tetanus immunity by “TQS”; ii) “Medical Interview” (current practice). The study population was 1,658,000 French adults seeking ED care for a wound in 2012. Model parameters were estimated based on French national surveillance data, and published literature. Outcome measures were number of tetanus cases, life years gained and costs (2012 €) from a societal perspective. RESULTS: Use of TQS had negligible impact on health outcomes (0.02 tetanus cases/year in France vs. 0.41 for “Medical Interview”), but resulted in a decrease in annual costs of €2,203,000 (-42%). Base case and sub-group analysis showed that with the same effectiveness, the average cost per patient was: €13 with “Medical Interview” vs. €11.7 with TQS for the overall cohort; €28.9 with “Medical Interview” vs. €21 with “TQS” for tetanus-prone wounds; €15 with “Medical Interview” vs. €14.1 with “TQS” for patients aged ≥65 years; and €6.2 with “Medical Interview” vs. €7.8 with “TQS” for non-tetanus-prone wounds. CONCLUSIONS: Use of TQS is as effective and less costly than “Medical Interview” when applied in ED to wounded patients with tetanus-prone wounds or aged ≥65 years. However, it is more expensive in patients with non-tetanus-prone wounds. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-014-0603-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-42466902014-11-29 Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments N'Diaye, Dieynaba S Schwarzinger, Michaël Obach, Dorothée Poissy, Julien Matheron, Sophie Casalino, Enrique Yazdanpanah, Yazdan BMC Infect Dis Research Article BACKGROUND: Tétanos Quick Stick® (TQS) is a test for tetanus immunity screening for wounded patients in emergency departments (EDs), but represents additional costs compared with a medical interview on vaccination history. The study objective was to assess the effectiveness and cost of the TQS in French EDs. METHODS: We performed a model-based analysis that simulates screening of tetanus immunity and risk of tetanus based on prophylaxis administration. Strategies compared were: i) diagnosis of tetanus immunity by “TQS”; ii) “Medical Interview” (current practice). The study population was 1,658,000 French adults seeking ED care for a wound in 2012. Model parameters were estimated based on French national surveillance data, and published literature. Outcome measures were number of tetanus cases, life years gained and costs (2012 €) from a societal perspective. RESULTS: Use of TQS had negligible impact on health outcomes (0.02 tetanus cases/year in France vs. 0.41 for “Medical Interview”), but resulted in a decrease in annual costs of €2,203,000 (-42%). Base case and sub-group analysis showed that with the same effectiveness, the average cost per patient was: €13 with “Medical Interview” vs. €11.7 with TQS for the overall cohort; €28.9 with “Medical Interview” vs. €21 with “TQS” for tetanus-prone wounds; €15 with “Medical Interview” vs. €14.1 with “TQS” for patients aged ≥65 years; and €6.2 with “Medical Interview” vs. €7.8 with “TQS” for non-tetanus-prone wounds. CONCLUSIONS: Use of TQS is as effective and less costly than “Medical Interview” when applied in ED to wounded patients with tetanus-prone wounds or aged ≥65 years. However, it is more expensive in patients with non-tetanus-prone wounds. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-014-0603-3) contains supplementary material, which is available to authorized users. BioMed Central 2014-11-19 /pmc/articles/PMC4246690/ /pubmed/25407690 http://dx.doi.org/10.1186/s12879-014-0603-3 Text en © N'Diaye et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
N'Diaye, Dieynaba S
Schwarzinger, Michaël
Obach, Dorothée
Poissy, Julien
Matheron, Sophie
Casalino, Enrique
Yazdanpanah, Yazdan
Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments
title Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments
title_full Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments
title_fullStr Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments
title_full_unstemmed Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments
title_short Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments
title_sort effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4246690/
https://www.ncbi.nlm.nih.gov/pubmed/25407690
http://dx.doi.org/10.1186/s12879-014-0603-3
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