I have worked on many diagnostic test evaluation and economic assessment. I
agree cost per case diagnosed is not appropriate. The net health effect
from a diagnostic test can only be evaluated if one construct a decision
tree. If one has the test results as TP, TN, FP and FN than the tree can be
simplified. If there is an underlying disease the test is trying to detect
than set the decision tree as disease + or disease -, prior to the test and
then branch out the tree. Alternatively one can use Bayes theorem.
Talat Ashraf MD, MSc, MS
> [Original Message]
> From: Dr A Coomarasamy <[log in to unmask]>
> To: <[log in to unmask]>
> Date: 8/8/01 6:07:21 AM
> Subject: Capturing the full economic consequences of diagnostic tests.
>
> Dear friends,
>
> We are planning to do an economic evaluation of two alternative diagnostic
> tests. Surveying the current literature, many authors report a
> cost-effectiveness ratio in the form of 'cost per case diagnosed' for
> economic evaluation of tests. However, this approach ignores the economic
> consequences of, for instance, false negatives and false postives that
> result from the alternative diagnostic tests. Reporting a unitary measure
> of effectiveness (cases found) whilst ignoring other substantial outcomes
> (value of true negatives, false positives and false negatives) does not
seem
> to capture the full economic consequences of alternative tests. If any of
> you are aware of any literature where this problem has been tackled, would
> you please let us know.
>
> Cheers!
>
> Arri
> Justin
>
> Dr A Coomarasamy, MRCOG
> Reseach Fellow Birmingham Women's Hospital, UK
--- Talat Ashraf
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