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
DOI
10.1007/s15010-019-01320-7