Meerding W J, Doornewaard H, van Ballegooijen M, Bos A, van der Graaf Y, van den Tweel J G, van der Schouw Y T, Habbema J D
Department of Public Health, Faculty of Medicine, Erasmus University, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
Acta Cytol. 2001 Jan-Feb;45(1):28-35. doi: 10.1159/000327184.
To assess the difference in costs between PAPNET-assisted and conventional microscopy of cervical smears when used as a primary screening tool.
We performed time measurements of the initial screening of smears by four cytotechnologists in one laboratory. Time was measured in 816 conventionally screened smears and in 614 smears with PAPNET-assisted screening. Data were collected on the components of initial screening, clerical activities and other activities in the total work time of cytotechnologists in the routine situation and on resource requirements for both techniques.
PAPNET saved an average of 22% on initial screening time per smear. Due to costs of processing and additional equipment, the costs of PAPNET-assisted screening were estimated to be $2.85 (and at least $1.79) higher per smear than conventional microscopy. The difference in costs is sensitive to the rate of time saving, the possibility of saving on quality control procedures and the component of the initial screening time in the total work time of cytotechnologists.
Although PAPNET is time saving as compared with conventional microscopy, the associated reduction in personnel costs is outweighed by the costs of scanning the slides and additional equipment. This conclusion holds under a variety of assumptions. Using PAPNET instead of conventional microscopy as a primary screening tool will make cervical cancer screening less cost-effective unless the costs of PAPNET are considerably reduced and its sensitivity and/or specificity are considerably improved.
评估将PAPNET辅助检查与传统宫颈涂片显微镜检查作为主要筛查工具时的成本差异。
我们对一个实验室的四名细胞技术人员进行涂片初次筛查的时间进行了测量。对816份采用传统方法筛查的涂片和614份采用PAPNET辅助筛查的涂片进行了时间测量。收集了常规情况下细胞技术人员总工作时间内初次筛查、文书工作及其他活动的组成部分的数据，以及两种技术的资源需求数据。
PAPNET使每份涂片的初次筛查时间平均节省了22%。由于处理成本和额外设备的原因，PAPNET辅助筛查的成本估计比传统显微镜检查每份涂片高出2.85美元（至少高出1.79美元）。成本差异对节省时间的比例、节省质量控制程序的可能性以及细胞技术人员总工作时间内初次筛查时间的组成部分较为敏感。
尽管与传统显微镜检查相比，PAPNET节省时间，但扫描玻片和额外设备的成本超过了相关的人员成本降低。这一结论在多种假设下均成立。除非PAPNET的成本大幅降低且其敏感性和/或特异性大幅提高，否则使用PAPNET而非传统显微镜检查作为主要筛查工具将使宫颈癌筛查的成本效益降低。
