Economic analysis of rapid multiplex polymerase chain reaction testing for meningitis/encephalitis in adult patients

Publication Date

2019

Journal Title

Infection

Abstract

© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Many patients with suspected meningitis do not require hospitalization yet are admitted, often resulting in unnecessary care and additional cost. We assessed the possible economic impact of a rapid multiplex test for suspected adult community-acquired meningitis/encephalitis. Methods: A model simulated diagnosis, clinical decisions, resource use/costs of standard of care (SOC) and two cerebrospinal fluid (CSF) testing strategies using the FDA-cleared BioFire® FilmArray® System (FA) which provides results in approximately one hour. Results: Pathogens detected by FA caused approximately 74% of cases, 97% of which would be accurately diagnosed with FA. False positives and false negatives more often led to extended/unnecessary admission than inappropriate discharge/missed admission. Mean cost per case ranged from 16829 to 20791. A strategy of testing all suspected cases yielded greater savings (2213/case) than testing only those with abnormal CSF (812/case) and both were less expensive than SOC. Conclusion: This economic analysis demonstrates that FA can inform more appropriate clinician decisions resulting in cost savings with greater economic benefits achievable with syndromic testing of all cases, rather than SOC or targeted syndromic testing.

Volume Number

47

Issue Number

6

Pages

945-953

Document Type

Article

Status

Faculty

Facility

School of Medicine

Primary Department

Pathology and Laboratory Medicine

Additional Departments

Molecular Medicine

PMID

31111325

DOI

10.1007/s15010-019-01320-7

For the public and Northwell Health campuses

Share

COinS