Cost-effectiveness analysis of diagnosis and management of cervical squamous intraepithelial lesions.

摘要: Abstract Objective: To compare five strategies for the diagnosis and treatment of cervical squamous intraepithelial lesions (SILs), including those that incorporate colposcopy a new technology, fluorescence spectroscopy. Methods: On basis health care perspective, we performed cost-effectiveness analysis using decision-analytic model management SILs. We compared based on expected costs number cases were treated appropriately, missed, inappropriately, appropriately not in hypothetical cohort 100 patients referred after an abnormal Papanicolaou smear. Data prevalence operating characteristics derived from medical literature. Costs adjusted hospital charge data. Results: A see-and-treat strategy spectroscopy was least expensive but effective strategy, costing $160,479 to detect 31.55 precancer accurately patients. The most colposcopically directed biopsy, at $311,808 find 45.78 cases; however, when both tests used modality, slightly more found (46.05) lower cost ($285,133). Other dominated base case. incremental joint with spectroscopy-only $8596 per case detected. Sensitivity showed sensitive technology Conclusion: Fluorescence should be considered important innovation SILs as demonstrated by its efficacy economic advantages.