Skip to main content

Cost-Effectiveness Analysis of Thyroid Testing Strategies

  • Chapter
Laboratory Data and Patient Care

Abstract

Over the past 14 years the techniques of clinical decision analysis and cost-effectiveness analysis have been introduced to medicine, and within the last decade these tools have been adopted by academic laboratory scientists. In today’s environment, the laboratory director must consider the introduction of new or enhanced laboratory tests as a comparative problem: how does the novel procedure or analyte fit into both the clinical information stream and in the milieu of existing tests?1 Although a considerable literature deals with problems of technical accuracy and precision in analytic laboratory medicine, this is not true for problems of clinical efficacy and economy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. J.R. Beck, The role of new laboratory tests in clinical decision making, Clin. Lab. Med. 2: 751 (1982).

    PubMed  CAS  Google Scholar 

  2. M.C. Weinstein, Cost-effectiveness analysis for medical practices: Appropriate laboratory utilization, in: “Logic and Economics of Clinical Laboratory Use”, E.S. Benson and M. Rubin, eds., Elsevier--North Holland Inc., New York (1978).

    Google Scholar 

  3. G.A. Gorry, Decision analysis: Principles for clinical application, in: “Logic and Economics of Clinical Laboratory Use”, E.S. Benson and M. Rubin, eds., Elsevier-North Holland Inc., New York (1978).

    Google Scholar 

  4. H. Büttner, Optimization of laboratory testing, in: “Logic and Economics of Clinical Laboratory Use”, E.S. Benson and M. Rubin, eds., Elsevier--North Holland Inc., New York (1978).

    Google Scholar 

  5. K.A. Epstein, L.J. Schneiderman, J.W. Bush and A. Zettner, The “abnormal” screening serum thyroxine (T4): Analysis of physician response, outcome, cost and health effectiveness, J. Chron. Dis. 34: 175 (1981).

    Article  PubMed  CAS  Google Scholar 

  6. J.M. Amberg, L.J. Schneiderman, C.C. Berry and A. Zettner, The abnormal outpatient chemistry panel serum alkaline phosphatase: Analysis of physician response, outcome, cost and health effectiveness, J. Chron. Dis. 35: 81 (1982).

    Article  PubMed  CAS  Google Scholar 

  7. P.E. Berwick and A.L. Komaroff, Cost-effectiveness of lead screening, New Engl. J. Med. 306: 1392 (1982).

    Article  PubMed  CAS  Google Scholar 

  8. J.R. Beck and F.A. Meier, Bayesian strategies in spontaneous bacterial peritonitis: Integration of test selection into clinical decision analysis, Scand. J. Clin. Lab. Invest. 44(suppl. 171): 97 (1984).

    Google Scholar 

  9. J. Büttner, Measuring the efficiency and effectiveness of clinical laboratory tests, in: “Optimal Use of the Clinical Laboratory”, O. Zinder, ed., Karger, Basel (1986).

    Google Scholar 

  10. M.C. Weinstein, Economic analysis of medical practices and technologies, Med Decis Making 1: 309 (1981).

    Article  PubMed  CAS  Google Scholar 

  11. M.H. Zweig, J.R. Beck, W.L. Collinsworth et al., “Assessment of Clinical Sensitivity and Specificity of Laboratory Tests”, National Committee for Clinical Laboratory Standards Document GP10-P, Villanova, PA (1987).

    Google Scholar 

  12. S.G. Pauker and J.P. Kassirer, The threshold approach to clinical decision making, New Engl. J. Med. 302: 1109 (1980).

    Article  PubMed  CAS  Google Scholar 

  13. W.E. Cobb, R.P. Lamberton and I.M.O. Jackson, Use of a rapid, sensitive immunoradiometric assay for thyrotropin to distinguish normal from hyperthyroid subjects, Clin. Chem. 30: 1558 (1984).

    PubMed  CAS  Google Scholar 

  14. E.T. Wong, M.M. McCarron and S.T. Shaw, Ordering of laboratory tests in a teaching hospital: Can it be improved?, JAMA 249: 3076 (1983).

    Article  PubMed  CAS  Google Scholar 

  15. J.P. Nolan, N.J. Tarsa and G. DiBenedetto, Case-finding for thyroid disease: Costs and health benefits, Am. J. Clin. Pathol. 83: 346 (1985).

    PubMed  CAS  Google Scholar 

  16. G. Caldwell, H.A. Kellett, S.M. Gow et al., A new strategy for thyroid function testing, Lancet 1: 1117 (1985).

    Article  PubMed  CAS  Google Scholar 

  17. W.M.G. Tunbridge, D.G. Evered, R. Hall et al., The spectrum of thyroid disease in a community: The Whickham survey, Clin. Endocrinol. 7: 481 (1977).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1988 Plenum Press, New York

About this chapter

Cite this chapter

Beck, J.R., Appleton, P.E., Shultz, E.K. (1988). Cost-Effectiveness Analysis of Thyroid Testing Strategies. In: Kerkhof, P.L.M., van Dieijen-Visser, M.P. (eds) Laboratory Data and Patient Care. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-0351-1_6

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-0351-1_6

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-0353-5

  • Online ISBN: 978-1-4757-0351-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics