Diagnosis and management of acute pharyngitis in a paediatric population: a cost–effectiveness analysis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Carolina Giraldez-Garcia & Beltran Rubio & Jose F Gallegos-Braun & Iٌaki Imaz & Jesus Gonzalez-Enriquez & Antonio Sarria-Santamera
- چاپ و سال / کشور: 2011
Description
Acute pharyngitis is one of the most frequent causes of primary care physician visits; however, there is no agreement about which is the best strategy to diagnose and manage acute pharyngitis in children. The aim of the current study was to evaluate the cost.effectiveness of the recommended strategies to diagnose and manage acute pharyngitis in a paediatric population. A decision tree analysis was performed to compare the following six strategies: پgtreat allپh, پgclinical scoringپh, پgrapid testپh, پgcultureپh, پgrapid test + cultureپh and پgclinical scoring + rapid testپh. The cost data came from the Spanish National Health Service sources. Cost.effectiveness was calculated from the payerپfs perspective. Effectiveness was measured as the proportion of patients cured without complications from the disease and did not have any reaction to penicillin therapy; a sensitivity analysis was performed. The findings revealed that the پgclinical scoring + rapid testپh strategy is the most cost-effective, with a cost.effectiveness ratio of 50.72 .. This strategy dominated all others except پgcultureپh, which was the most effective but also the most costly. The sensitivity analysis showed that پgrapid testپh became the most cost-effective strategy when the clinical scoring sensitivity was <91% and its specificity was .9%. In conclusion, the use of a clinical scoring system to triage the diagnoses and performing a rapid antigen test for those with a high score is the most cost-effective strategy for the diagnosis and management of acute pharyngitis in children. When the clinical scoring system has a low diagnostic accuracy, testing all patients with rapid test becomes the most cost-effective strategy.
Eur J Pediatr (2011) 170:1059–1067 DOI 10.1007/s00431-011-1410-0 Received: 14 November 2010 / Accepted: 24 January 2011 / Published online: 11 February 2011
