Jones, William S., Rice, Stephen, Power, H. Michael, Maniatopoulos, Gregory, Suklan, Jana, Beyer, Fiona, Wilcox, Mark H., Permain, Michelle, Simpson, A. John, Price, D. Ashley and Allen, A. Joy (2020) Cost Consequences for the NHS of Using a Two-Step Testing Method for the Detection of Clostridium difficile with a Point of Care, Polymerase Chain Reaction Test as the First Step. Diagnostics, 10 (10). p. 819. ISSN 2075-4418
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Abstract
Clostridium difficile infection (CDI) is a common healthcare-associated infection. Current practice for diagnosing CDI in the Newcastle upon Tyne Hospitals NHS Foundation Trust involves a three-step, laboratory testing strategy using glutamate dehydrogenase (GDH) enzyme immunoassay (EIA), followed by a polymerase chain reaction (PCR) test then a toxin EIA. However, a PCR point of care test (POCT) for the C. difficile tcdB gene for screening suspected CDI cases, may provide a more efficient way of facilitating an equally effective, two-step, testing strategy with a toxin EIA. This study evaluated the cost consequences of changing from the three-step to a two-step testing strategy. A cost-consequences model was developed to compare the costs and consequences of the two strategies. Uncertainties in the model inputs were investigated with one- and two-way sensitivity analysis. The two-step, POCT strategy was estimated to save £283,282 per 1000 hospitalized NHS patients with suspected infectious diarrhea. Sensitivity analysis indicated that the turnaround time for the POCT was the largest driver for cost savings. Providing the POCT has sufficiently high diagnostic accuracy for detecting C. difficile, the two-step, POCT strategy for CDI identification is likely to be cost saving for NHS hospitals with an offsite laboratory.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding information: Funding for this study was provided by Meridian Bioscience, Cincinnati, US. All aspects of the research were performed by the NIHR Newcastle in vitro Diagnostics Co-operative (NIHR Newcastle MIC), see ‘Author’s contributions’ for specifics. Meridian Bioscience collaborated with the overall design of the study and approved the manuscript before submission for publication. The final decision for manuscript submission was made by the NIHR Newcastle MIC; the funder did not have a right to veto such decision. |
| Uncontrolled Keywords: | point-of-care testing; Clostridium difficile; C. diff; health economics; cost-analysis; cost-consequences; infection control |
| Subjects: | B900 Others in Subjects allied to Medicine L400 Social Policy |
| Department: | Faculties > Business and Law > Newcastle Business School |
| Depositing User: | Elena Carlaw |
| Date Deposited: | 26 Jul 2022 08:32 |
| Last Modified: | 26 Jul 2022 08:45 |
| URI: | http://nrl.northumbria.ac.uk/id/eprint/49613 |
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