Utilization of Common Inflammatory Markersin New, Symptomatic, Primary Care OutpatientsBased on Their Cost-Effectiveness

Verfasser / Beitragende:
[Yuzuru Takemura, Haku Ishida, Yuji Inoue]
Ort, Verlag, Jahr:
2003
Enthalten in:
Clinical Chemistry and Laboratory Medicine, 41/5(2003-05-15), 668-674
Format:
Artikel (online)
ID: 378875973
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024 7 0 |a 10.1515/CCLM.2003.101  |2 doi 
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245 0 0 |a Utilization of Common Inflammatory Markersin New, Symptomatic, Primary Care OutpatientsBased on Their Cost-Effectiveness  |h [Elektronische Daten]  |c [Yuzuru Takemura, Haku Ishida, Yuji Inoue] 
520 3 |a Few studies have demonstrated the optimal usage of common inflammatory markers, alone or in combination, based on the cost-effectiveness. We analyzed the yield and cost of C-reactive protein (CRP), white blood cell count (WBC), erythrocyte sedimentation rate (ESR), sialic acid, and protein fractionation in 177 new primary care outpatients with inflammation-related symptoms. A useful result (UR) was assigned if tests contributed to a change in physician's diagnosis or decision-making. Costs of testing were calculated based on either single or simultaneous measurement. Five inflammatory markers generated 147 URs in 123 patients. CRP showed the best contribution to generation of UR, followed by sialic acid, protein fractionation, WBC, and ESR. CRP demonstrated poor correlation with WBC (r = 0.458), while sialic acid strongly correlated with total absolute amount of α1 and α2 fractions in protein fractionation (r = 0.855) and moderately with ESR (r = 0.651). The combination of CRP and WBC produced the best cost-effectiveness at a cost of ¥ 1169 (US$ 9.6 or Euro 9.7)/additional UR against CRP testing alone. Sialic acid, an automated multichannel analyzer-based test, demonstrated the favorable cost-effectiveness over ESR or protein fractionation when combined with CRP (and WBC). Our results indicate that the optimal usage of these inflammatory markers should involve careful cost-effectiveness considerations. 
540 |a Copyright © 2003 by Walter de Gruyter GmbH & Co. KG 
690 7 |a Medical equipment & techniques  |2 nationallicence 
690 7 |a Medical diagnosis  |2 nationallicence 
690 7 |a Diseases & disorders  |2 nationallicence 
700 1 |a Takemura  |D Yuzuru  |4 aut 
700 1 |a Ishida  |D Haku  |4 aut 
700 1 |a Inoue  |D Yuji  |4 aut 
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950 |B NATIONALLICENCE  |P 773  |E 0-  |t Clinical Chemistry and Laboratory Medicine  |d Walter de Gruyter  |g 41/5(2003-05-15), 668-674  |x 1434-6621  |q 41:5<668  |1 2003  |2 41  |o cclm 
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