Diagnosis and management of pharyngitis in a pediatric population based on cost-effectiveness and projected health outcomes

Pediatrics
Robert S Van Howe, Louis P Kusnier

Abstract

Pharyngitis is a common childhood complaint. Current management for children and adolescents includes 1 of 6 strategies, ie, (1) observe without testing or treatment, (2) treat all suspected cases with an antibiotic, (3) treat those with positive throat cultures, (4) treat those with positive rapid tests, (5) treat those with positive rapid tests and those with positive throat cultures after negative rapid tests, or (6) use a clinical scoring measure to determine the diagnosis/treatment strategy. The sequelae of untreated group A hemolytic streptococcal (GAS) pharyngitis are rare, whereas antibiotic treatment may result in side effects ranging from rash to death. The cost-utility of these strategies for children has not been reported previously. A decision tree analysis incorporating the total cost and health impact of each management strategy was used to determine cost per quality-adjusted life-year ratios. Sensitivity analyses and Monte Carlo simulations assessed the accuracy of the estimates. From a societal perspective with current Medicaid reimbursements for testing, performing a throat culture for all patients had the best cost-utility. For private insurance reimbursements, rapid antigen testing had the best cost-utility....Continue Reading

References

Jan 1, 1992·European Journal of Clinical Pharmacology·M De MeyereM Bogaert
Jul 1, 1987·Journal of General Internal Medicine·B E Hillner, R M Centor
Jun 1, 1985·The Journal of Pediatrics·M F RandolphL Wright
Feb 1, 1995·Diagnostic Microbiology and Infectious Disease·D M BakerH P Dalton
Jul 13, 1999·Archives of Pediatrics & Adolescent Medicine·J Tsevat, U R Kotagal
Aug 10, 2000·Medical Decision Making : an International Journal of the Society for Medical Decision Making·R A HirthW G Weissert
Mar 20, 2001·Annals of Internal Medicine·R J CooperUNKNOWN Centers for Disease Control
Jun 28, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Alan L BisnoUNKNOWN Infectious Diseases Society of America
Jul 16, 2003·Annals of Internal Medicine·Joan M NeunerMark D Aronson
Apr 8, 2004·JAMA : the Journal of the American Medical Association·Warren J McIsaacDonald E Low
Apr 24, 2004·The Cochrane Database of Systematic Reviews·C B Del MarA B Spinks
Jun 3, 2004·Pediatrics·Stanford T Shulman, Michael A Gerber

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Citations

Aug 14, 2012·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·S BankJ Prag
Aug 16, 2011·The Permanente Journal·Debra P RitzwollerDavid Bergman
Feb 11, 2011·European Journal of Pediatrics·Carolina Giraldez-GarciaAntonio Sarria-Santamera
Jan 30, 2010·Expert Review of Anti-infective Therapy·Stanford T Shulman, Robert R Tanz
Dec 20, 2011·La Presse médicale·Abdelkader MaiziaCyrille Colin
Jan 13, 2009·Acta Paediatrica·Judith Barash
Apr 25, 2013·Journal of Clinical Pharmacy and Therapeutics·D PiovaniUNKNOWN PeFAB group
Jun 14, 2012·Clinical Therapeutics·Elena ChiappiniUNKNOWN Italian Panel on the Management of Pharyngitis in Children
Dec 17, 2014·Revista paulista de pediatria : orgão oficial da Sociedade de Pediatria de São Paulo·Aurelino Rocha Barbosa JúniorE Paulo Augusto Moreira Camargos
Jan 9, 2008·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Alan R Salkind, Julie M Wright
Jul 16, 2021·PharmacoEconomics·Simon van der PolAntoinette D I van Asselt
Jul 1, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kristin AndrejkoJoseph A Lewnard
Aug 10, 2021·Health Economics Review·F AntoñanzasR Rodríguez-Ibeas
Sep 30, 2021·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Minkyoung YooRichard E Nelson

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