A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis
Most models of infectious diseases, including tuberculosis (TB), do not provide results customized to local conditions. We created a dynamic transmission model to project TB incidence, TB mortality, multidrug-resistant (MDR) TB prevalence, and incremental costs over 5 years after scale-up of nine al...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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eLife Sciences Publications Ltd
2014-06-01
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| Series: | eLife |
| Subjects: | |
| Online Access: | https://elifesciences.org/articles/02565 |
| _version_ | 1811200112638033920 |
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| author | David W Dowdy Jason R Andrews Peter J Dodd Robert H Gilman |
| author_facet | David W Dowdy Jason R Andrews Peter J Dodd Robert H Gilman |
| author_sort | David W Dowdy |
| collection | DOAJ |
| description | Most models of infectious diseases, including tuberculosis (TB), do not provide results customized to local conditions. We created a dynamic transmission model to project TB incidence, TB mortality, multidrug-resistant (MDR) TB prevalence, and incremental costs over 5 years after scale-up of nine alternative diagnostic strategies. A corresponding web-based interface allows users to specify local costs and epidemiology. In settings with little capacity for up-front investment, same-day microscopy had the greatest impact on TB incidence and became cost-saving within 5 years if delivered at $10/test. With greater initial investment, population-level scale-up of Xpert MTB/RIF or microcolony-based culture often averted 10 times more TB cases than narrowly-targeted strategies, at minimal incremental long-term cost. Xpert for smear-positive TB had reasonable impact on MDR-TB incidence, but at substantial price and little impact on overall TB incidence and mortality. This user-friendly modeling framework improves decision-makers' ability to evaluate the local impact of TB diagnostic strategies. |
| first_indexed | 2024-04-12T01:59:19Z |
| format | Article |
| id | doaj.art-81da67679fab48bc9d1968a78e997ca3 |
| institution | Directory Open Access Journal |
| issn | 2050-084X |
| language | English |
| last_indexed | 2024-04-12T01:59:19Z |
| publishDate | 2014-06-01 |
| publisher | eLife Sciences Publications Ltd |
| record_format | Article |
| series | eLife |
| spelling | doaj.art-81da67679fab48bc9d1968a78e997ca32022-12-22T03:52:43ZengeLife Sciences Publications LtdeLife2050-084X2014-06-01310.7554/eLife.02565A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosisDavid W Dowdy0Jason R Andrews1Peter J Dodd2Robert H Gilman3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States; Center for Tuberculosis Research, Johns Hopkins University, Baltimore, United StatesDivision of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, United StatesSchool of Health and Related Research, University of Sheffield, Sheffield, United KingdomDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United StatesMost models of infectious diseases, including tuberculosis (TB), do not provide results customized to local conditions. We created a dynamic transmission model to project TB incidence, TB mortality, multidrug-resistant (MDR) TB prevalence, and incremental costs over 5 years after scale-up of nine alternative diagnostic strategies. A corresponding web-based interface allows users to specify local costs and epidemiology. In settings with little capacity for up-front investment, same-day microscopy had the greatest impact on TB incidence and became cost-saving within 5 years if delivered at $10/test. With greater initial investment, population-level scale-up of Xpert MTB/RIF or microcolony-based culture often averted 10 times more TB cases than narrowly-targeted strategies, at minimal incremental long-term cost. Xpert for smear-positive TB had reasonable impact on MDR-TB incidence, but at substantial price and little impact on overall TB incidence and mortality. This user-friendly modeling framework improves decision-makers' ability to evaluate the local impact of TB diagnostic strategies.https://elifesciences.org/articles/02565tuberculosisdiagnostic techniques and proceduresepidemiologyinfectious disease transmissioneconomic model |
| spellingShingle | David W Dowdy Jason R Andrews Peter J Dodd Robert H Gilman A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis eLife tuberculosis diagnostic techniques and procedures epidemiology infectious disease transmission economic model |
| title | A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis |
| title_full | A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis |
| title_fullStr | A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis |
| title_full_unstemmed | A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis |
| title_short | A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis |
| title_sort | user friendly open source tool to project impact and cost of diagnostic tests for tuberculosis |
| topic | tuberculosis diagnostic techniques and procedures epidemiology infectious disease transmission economic model |
| url | https://elifesciences.org/articles/02565 |
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