Raab S S
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, 52242-1009, USA.
Am J Clin Pathol. 1997 Nov;108(5):525-36. doi: 10.1093/ajcp/108.5.525.
Although most laboratories practice 10% manual rescreening, the cost-effectiveness of this and other rescreening strategies rarely has been evaluated. Using data obtained from the medical literature, a decision model was created in which rescreening strategies were compared with nonrescreening strategies for the number of false-negative and false-positive diagnoses, cancers, life expectancy, and cost-effectiveness. The strategy of 10% rescreening with a repeated cervical-vaginal smear yielded almost no gain in life expectancy compared with an equivalent strategy with no rescreening. With 100% rescreening, the gain in life expectancy was only 0.24 days per patient. A 100% rescreening strategy generally was more cost-effective than a no-rescreening strategy at costs of rescreening varying from $2 to $10 per patient. A 10% rescreening strategy has limited utility. In addition, 100% rescreening strategies are more cost-effective than nonrescreening strategies, but only if the rescreening cost is low.
尽管大多数实验室采用10%的人工复查，但这种及其他复查策略的成本效益很少得到评估。利用从医学文献中获取的数据，创建了一个决策模型，在该模型中，将复查策略与非复查策略在假阴性和假阳性诊断数量、癌症、预期寿命及成本效益方面进行了比较。与不进行复查的等效策略相比，采用重复宫颈阴道涂片进行10%复查的策略在预期寿命方面几乎没有增加。进行100%复查时，每位患者的预期寿命仅增加0.24天。在每位患者的复查成本从2美元到10美元不等的情况下，100%复查策略通常比不复查策略更具成本效益。10%复查策略的效用有限。此外，100%复查策略比不复查策略更具成本效益，但前提是复查成本较低。
