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Cost reduction in diagnosing Pneumocystis carinii pneumonia. Sputum induction versus bronchoalveolar lavage as the initial diagnostic procedure.
Am Rev Respir Dis. 1992 Jun; 145(6):1425-8.AR

Abstract

Sputum induction (SI) is a sensitive and specific method for diagnosing Pneumocystis carinii pneumonia (PCP) in patients with AIDS. Although less expensive than bronchoscopy with bronchoalveolar lavage (BAL), SI followed by BAL does not necessarily reduce costs compared with BAL alone. Cost analysis demonstrates that the cost of diagnosing PCP is dependent on the prevalence of PCP (PCPprevalence) in the studied population, the sensitivity of SI (SIsensitivity) for diagnosing PCP, and the relative costs of SI and BAL (SIcost and BALcost) for diagnosing PCP. In any given clinical setting, SI reduces the cost of diagnosing PCP if (PCPprevalence)(SIsensitivity) greater than SIcost/BALcost. A graphic approach relating these parameters is also presented. Evaluation of reported PCPprevalence and SIsensitivity from recent literature illustrates that SI is not always the least costly method for diagnosing PCP. Cost reduction is not the only measure of a diagnostic procedure's value, and other aspects, such as discomfort, availability, risks, and patient prognosis, must be considered. The cost analysis approach used in this study identifies those variables that can be manipulated to reduce the cost of diagnosing PCP.

Authors+Show Affiliations

Glenny RW
Department of Medicine, University of Washington, Seattle.
Pierson DJ
No affiliation info available

MeSH

Acquired Immunodeficiency SyndromeBronchoalveolar Lavage FluidCost ControlCosts and Cost AnalysisHumansPneumonia, PneumocystisSensitivity and SpecificitySputum

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

1596013

Citation

Glenny, R W., and D J. Pierson. "Cost Reduction in Diagnosing Pneumocystis Carinii Pneumonia. Sputum Induction Versus Bronchoalveolar Lavage as the Initial Diagnostic Procedure." The American Review of Respiratory Disease, vol. 145, no. 6, 1992, pp. 1425-8.
Glenny RW, Pierson DJ. Cost reduction in diagnosing Pneumocystis carinii pneumonia. Sputum induction versus bronchoalveolar lavage as the initial diagnostic procedure. Am Rev Respir Dis. 1992;145(6):1425-8.
Glenny, R. W., & Pierson, D. J. (1992). Cost reduction in diagnosing Pneumocystis carinii pneumonia. Sputum induction versus bronchoalveolar lavage as the initial diagnostic procedure. The American Review of Respiratory Disease, 145(6), 1425-8.
Glenny RW, Pierson DJ. Cost Reduction in Diagnosing Pneumocystis Carinii Pneumonia. Sputum Induction Versus Bronchoalveolar Lavage as the Initial Diagnostic Procedure. Am Rev Respir Dis. 1992;145(6):1425-8. PubMed PMID: 1596013.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost reduction in diagnosing Pneumocystis carinii pneumonia. Sputum induction versus bronchoalveolar lavage as the initial diagnostic procedure. AU - Glenny,R W, AU - Pierson,D J, PY - 1992/6/1/pubmed PY - 1992/6/1/medline PY - 1992/6/1/entrez SP - 1425 EP - 8 JF - The American review of respiratory disease JO - Am Rev Respir Dis VL - 145 IS - 6 N2 - Sputum induction (SI) is a sensitive and specific method for diagnosing Pneumocystis carinii pneumonia (PCP) in patients with AIDS. Although less expensive than bronchoscopy with bronchoalveolar lavage (BAL), SI followed by BAL does not necessarily reduce costs compared with BAL alone. Cost analysis demonstrates that the cost of diagnosing PCP is dependent on the prevalence of PCP (PCPprevalence) in the studied population, the sensitivity of SI (SIsensitivity) for diagnosing PCP, and the relative costs of SI and BAL (SIcost and BALcost) for diagnosing PCP. In any given clinical setting, SI reduces the cost of diagnosing PCP if (PCPprevalence)(SIsensitivity) greater than SIcost/BALcost. A graphic approach relating these parameters is also presented. Evaluation of reported PCPprevalence and SIsensitivity from recent literature illustrates that SI is not always the least costly method for diagnosing PCP. Cost reduction is not the only measure of a diagnostic procedure's value, and other aspects, such as discomfort, availability, risks, and patient prognosis, must be considered. The cost analysis approach used in this study identifies those variables that can be manipulated to reduce the cost of diagnosing PCP. SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/1596013/Cost_reduction_in_diagnosing_Pneumocystis_carinii_pneumonia__Sputum_induction_versus_bronchoalveolar_lavage_as_the_initial_diagnostic_procedure_ DB - PRIME DP - Unbound Medicine ER -