Copyright (c) 1996 Elsevier Science B.V. All rights reserved.
To determine the most cost-effective strategy for newborn hemoglobinopathy screening from the perspective of state health care systems.
Using Alaska as an example, we used decision analysis to compare a policy of no screening to universal or targeted screening with selective follow-up only of infants who are homozygous or compound heterozygous for an abnormal hemoglobin variant and to universal or targeted screening with complete follow-up, including follow-up of infants with clinically insignificant traits.
Probabilities and costs were varied over values that might be expected for other states.
Among the selective follow-up options, targeted screening would be the most cost-effective strategy for Alaska at a cost of ? 206192 per death averted ; by contrast, universal screening would prevent 50% more deaths at an incremental cost of ? 2040000 per death averted.
Universal would be more cost-effective than targeted screening for several scenarios expected to occur in other states, including a high sickle cell disease prevalence, a low screening test cost, and a high cost per screen associated with racial targeting. (...)
Mots-clés Pascal : Dépistage, Coût, Optimisation, Anémie hématie falciforme, Hémopathie, Anémie hémolytique, Hémoglobinopathie, Maladie héréditaire, Alaska, Etats Unis, Amérique du Nord, Amérique, Nouveau né, Homme
Mots-clés Pascal anglais : Medical screening, Costs, Optimization, Sickle cell anemia, Hemopathy, Hemolytic anemia, Hemoglobinopathy, Genetic disease, Alaska, United States, North America, America, Newborn, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0395235
Code Inist : 002B19A01. Création : 10/04/1997.