Modelling the cost-effectiveness and capacity impact of changes to colposcopy referral guidelines for women with mild dyskaryosis in the UK Cervical Screening Programme

BJOG : an International Journal of Obstetrics and Gynaecology
R HadwinH Pilgrim

Abstract

To evaluate the capacity implications and health economic impact of new guidelines recommending referral to colposcopy after one mild result during cervical screening rather than after two consecutive mild results. A mathematical model of the country's colposcopy services and the clinical pathways from smear result through to treatment is constructed. The model incorporates national questionnaire data on referral numbers and management practices, routine data and published research results. All English NHS colposcopy services. Women aged 25 to 64 years. The national average workload impact of the change in referral guidelines is predicted, and the impact in differing local circumstances is evaluated within the model. A long-term health economic model examines the resulting costs and predicted change in quality-adjusted life years (QALYs). Colposcopy workload implications for single mild dyskaryosis referral and cost per QALY analysis. We found that single mild dyskaryosis referral implies, on average, a 21% increase in colposcopy workload for services not currently operating this policy. The health economic model predicted a cost per QALY gained as a result of the implementation of the new referral guidelines of around pound7,5...Continue Reading

References

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Jul 23, 2005·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Heather A CubieUNKNOWN National Cervical Screening Committee LBC/HPV Pilot Steering Group

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Citations

Apr 13, 2007·Archives of Gynecology and Obstetrics·Banchhita SahuS Aboel Magd
Sep 13, 2000·Cytopathology : Official Journal of the British Society for Clinical Cytology·O IfaturotiM H Jones
Feb 6, 2008·Journal de gynécologie, obstétrique et biologie de la reproduction·J-L MerguiS Uzan
Aug 10, 2018·Australian Health Review : a Publication of the Australian Hospital Association·Xing Ju LeeSanjeewa Kularatna

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