Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO box 85500, 3508 GA, Utecht, The Netherlands.
Expert Rev Mol Diagn. 2015 Jan;15(1):125-36. doi: 10.1586/14737159.2015.976202.
Point-of-care (POC) D-dimer tests have been developed to exclude deep venous thrombosis quickly and on the spot, but are known to have lower sensitivity compared with laboratory-based tests. Their cost-effectiveness is still unknown.
We updated and extended a previously published Markov model to assess the cost-effectiveness of POC D-dimer tests ('Simplify', 'Cardiac', 'Triage' and 'Nycocard') compared with a laboratory-based latex assay to diagnose deep venous thrombosis in primary care.
The 'Laboratory' strategy resulted in 6.986 quality-adjusted life years at the cost of €8354 per patient. All POC D-dimer tests resulted in health outcomes similar to the 'Laboratory' strategy. The 'Simplify' strategy maximized cost savings (-€155 [95% CI: -€246 to -€83]).
POC D-dimer tests yield similar health outcomes as laboratory-based testing procedures but can be performed more easily and at lower costs. Therefore, these tests are an alternative to laboratory-based testing and might be considered for exclusion of deep venous thrombosis in primary care.
即时检测（POC）D-二聚体检测旨在快速且就地排除深静脉血栓，但已知其敏感性低于基于实验室的检测。其成本效益尚不清楚。
我们更新并扩展了之前发表的一项马尔可夫模型，以评估 POC D-二聚体检测（“Simplify”、“Cardiac”、“Triage”和“Nycocard”）与基于实验室的乳胶检测相比在初级保健中诊断深静脉血栓的成本效益。
“实验室”策略导致 6.986 个质量调整生命年，每位患者的成本为 8354 欧元。所有 POC D-二聚体检测的健康结果均与“实验室”策略相似。“Simplify”策略最大限度地节省了成本（-155 欧元[95%CI：-246 至-83]）。
POC D-二聚体检测与基于实验室的检测程序产生相似的健康结果，但操作更简单，成本更低。因此，这些测试是实验室检测的替代方法，可能被考虑用于排除初级保健中的深静脉血栓。
