Randolph A G, Washington A E
Medical Scholars Program, Stanford University School of Medicine, San Francisco, CA.
Am J Public Health. 1990 May;80(5):545-50. doi: 10.2105/ajph.80.5.545.
To evaluate the cost and benefits of screening tests for Chlamydia trachomatis in adolescent males, we developed a decision analysis model and compared the leukocyte esterase urine dipstick test with culture, with direct-smear fluorescent antibody (DFA), and with the option of no screening (no treatment). The leukocyte esterase test has the lowest average cost-per-cure ($51) compared with direct-smear fluorescent antibody ($192) and culture ($414). Compared with the DFA, we estimate that the leukocyte esterase test saves over $9,727 per cohort of 1,000 sexually active adolescent males screened. Sensitivity analyses show the leukocyte esterase test results in a lower cost-per-cure and lower overall costs (per cohort) than culture and direct-smear fluorescent antibody at any prevalence of C. trachomatis infection, and lower overall costs (per cohort) than no screening at prevalences above 21 percent.
为评估对青春期男性进行沙眼衣原体筛查检测的成本和效益，我们开发了一个决策分析模型，并将白细胞酯酶尿试纸检测与培养法、直接涂片荧光抗体法（DFA）以及不进行筛查（不治疗）的选项进行了比较。与直接涂片荧光抗体法（192美元）和培养法（414美元）相比，白细胞酯酶检测的平均每治愈一例成本最低（51美元）。与DFA相比，我们估计，对于每1000名接受筛查的性活跃青春期男性队列，白细胞酯酶检测可节省超过9727美元。敏感性分析表明，在沙眼衣原体感染的任何患病率下，白细胞酯酶检测的每治愈一例成本和总体成本（每队列）均低于培养法和直接涂片荧光抗体法，且在患病率高于21%时，总体成本（每队列）低于不进行筛查的情况。
