Should women be tested for gonococcal infection of the cervix during routine gynecologic visits? An economic appraisal

The American Journal of Medicine
R S PhillipsW C Taylor

Abstract

We used decision analysis to calculate the economic implications of routine testing for Neisseria gonorrhoeae infection of the cervix. This study compared performing endocervical cultures in all women seeking routine gynecologic care to a no-test strategy. Estimates derived from the medical literature were varied in a sensitivity analysis, and a Monte Carlo technique was used to incorporate the estimates of experts into the analysis. We found that routinely testing for gonorrhea reduced overall medical costs when the prevalence of infection exceeded 1.5 percent. This result was most sensitive to variation in the cost of the culture and the assumption that treatment prevents adverse sequelae. Reducing the estimated cost of the culture from $9 to $5 decreased the threshold prevalence from 1.5 to 0.8 percent. When we considered the variation in estimates of experts, the threshold prevalence increased from 1.5 to 2.1 percent. We conclude that a strategy of testing and treating selected women with risk factors for gonorrhea will not only reduce the likelihood of the development of serious adverse sequelae but will also result in a reduction of medical costs.

References

Aug 10, 1978·The New England Journal of Medicine·M C Weinstein
Aug 14, 1987·JAMA : the Journal of the American Medical Association·C R HorsburghF M LaForce
Mar 27, 1987·JAMA : the Journal of the American Medical Association
Apr 1, 1986·Medical Decision Making : an International Journal of the Society for Medical Decision Making·G C Critchfield, K E Willard
Jan 1, 1985·Medical Decision Making : an International Journal of the Society for Medical Decision Making·P DoubiletB J McNeil
Apr 4, 1986·JAMA : the Journal of the American Medical Association·A E WashingtonM A Brooks
Oct 13, 1969·JAMA : the Journal of the American Medical Association·J D SchmaleG Domescik
Aug 1, 1982·Annals of Internal Medicine·R C BrunhamK K Holmes
May 15, 1980·The New England Journal of Medicine·S G Pauker, J P Kassirer

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Citations

Jun 29, 1999·Pediatric Clinics of North America·A P Acquavella, P Braverman
Jan 1, 1993·Infectious Diseases in Obstetrics and Gynecology·S Faro
Oct 7, 1997·American Journal of Public Health·K J MertzA Hadgu
Mar 1, 1993·Baillière's Clinical Obstetrics and Gynaecology·G L Gilbert
Jul 1, 1990·Journal of General Internal Medicine·G E RosenthalC S Landefeld

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