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To Test or to Treat? An Analysis of Influenza Testing and Antiviral Treatment Strategies Using Economic Computer Modeling

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  • Bruce Y Lee
  • Sarah M McGlone
  • Rachel R Bailey
  • Ann E Wiringa
  • Shanta M Zimmer
  • Kenneth J Smith
  • Richard K Zimmerman

Abstract

Background: Due to the unpredictable burden of pandemic influenza, the best strategy to manage testing, such as rapid or polymerase chain reaction (PCR), and antiviral medications for patients who present with influenza-like illness (ILI) is unknown. Methodology/Principal Findings: We developed a set of computer simulation models to evaluate the potential economic value of seven strategies under seasonal and pandemic influenza conditions: (1) using clinical judgment alone to guide antiviral use, (2) using PCR to determine whether to initiate antivirals, (3) using a rapid (point-of-care) test to determine antiviral use, (4) using a combination of a point-of-care test and clinical judgment, (5) using clinical judgment and confirming the diagnosis with PCR testing, (6) treating all with antivirals, and (7) not treating anyone with antivirals. For healthy younger adults (

Suggested Citation

  • Bruce Y Lee & Sarah M McGlone & Rachel R Bailey & Ann E Wiringa & Shanta M Zimmer & Kenneth J Smith & Richard K Zimmerman, 2010. "To Test or to Treat? An Analysis of Influenza Testing and Antiviral Treatment Strategies Using Economic Computer Modeling," PLOS ONE, Public Library of Science, vol. 5(6), pages 1-11, June.
    • Handle: RePEc:plo:pone00:0011284
    DOI: 10.1371/journal.pone.0011284
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    References listed on IDEAS

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    1. Simon G. Thompson & Richard M. Nixon, 2005. "How Sensitive Are Cost-Effectiveness Analyses to Choice of Parametric Distributions?," Medical Decision Making, , vol. 25(4), pages 416-423, July.
    2. Andrew H. Briggs & Ron Goeree & Gord Blackhouse & Bernie J. O’Brien, 2002. "Probabilistic Analysis of Cost-Effectiveness Models: Choosing between Treatment Strategies for Gastroesophageal Reflux Disease," Medical Decision Making, , vol. 22(4), pages 290-308, August.
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    Cited by:

    1. Román Pérez Velasco & Naiyana Praditsitthikorn & Kamonthip Wichmann & Adun Mohara & Surachai Kotirum & Sripen Tantivess & Constanza Vallenas & Hande Harmanci & Yot Teerawattananon, 2012. "Systematic Review of Economic Evaluations of Preparedness Strategies and Interventions against Influenza Pandemics," PLOS ONE, Public Library of Science, vol. 7(2), pages 1-9, February.
    2. Carlos Wong & Minghuan Jiang & Joyce H S You, 2016. "Potential Cost-Effectiveness of an Influenza Vaccination Program Offering Microneedle Patch for Vaccine Delivery in Children," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-13, December.

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