Emerg Infect Dis. 2020 Feb;26(2):238-246. doi: 10.3201/eid2602.181772.
In the aftermath of a large Q fever (QF) epidemic in the Netherlands during 2007-2010, new chronic QF (CQF) patients continue to be detected. We developed a health-economic decision model to evaluate the cost-effectiveness of a 1-time screening program for CQF 7 years after the epidemic. The model was parameterized with spatial data on QF notifications for the Netherlands, prevalence data from targeted screening studies, and clinical data from the national QF database. The cost-effectiveness of screening varied substantially among subpopulations and geographic areas. Screening that focused on cardiovascular risk patients in areas with high QF incidence during the epidemic ranged from cost-saving to €31,373 per quality-adjusted life year gained, depending on the method to estimate the prevalence of CQF. The cost per quality-adjusted life year of mass screening of all older adults was €70,000 in the most optimistic scenario.
在 2007 年至 2010 年荷兰大规模 Q 热（QF）疫情之后，新的慢性 QF（CQF）患者仍在不断被发现。我们开发了一种健康经济学决策模型，以评估疫情发生 7 年后针对 CQF 的一次性筛查计划的成本效益。该模型的参数包括荷兰 QF 通知的空间数据、有针对性筛查研究的流行率数据以及国家 QF 数据库的临床数据。筛查在不同人群和地理区域的成本效益差异很大。在疫情期间 QF 发病率较高的地区，针对心血管风险患者的筛查，其成本效益从节省成本到每获得一个质量调整生命年节省 31373 欧元不等，具体取决于用于估计 CQF 流行率的方法。在最乐观的情况下，对所有老年人进行大规模筛查的每质量调整生命年成本为 70000 欧元。
