Table 1 Studies focused on chlamydia ordered alphabetically by author's name.
Author | Intervention | Setting | Country | Quality | Static/dynamic model | Main CE findings |
---|---|---|---|---|---|---|
Adams et al (2004)4 | Opportunistic screening and partner notification | GUM clinics, family planning clinics, antenatal clinics, termination of pregnancy clinics, GP clinics | UK | + | Static | £38.38 cost per positive episode (2001 value) |
Blake et al (2004)5 | Universal screening of males with NAAT including partner follow up | Detention facilities | US | + | Static | $172k for 62 PID cases avoided; $148k for 99 PID cases avoided (year unclear) |
Buhaug et al (1990)6 | Screening for chlamydia | Women undergoing gynaecological examinations in primary care | Norway | + | Static | Age 16 net saving NKr 42 PID cases avoided, age 34 net cost NKr1,536 |
Cohen et al (1998)7 | Screening for chlamydia | School | USA | – | Static | $272 cost per infected student (year unclear) |
Dryden et al (1994)8 | Screening for chlamydia | Primary care | UK | – | Static | £245.78 cost per cure (year unclear) |
Genc (1996)9 | Screening (DNA amplification assays or ligase chain reaction) with standard practice | Primary care | Sweden | – | Static | Not explicitly stated but concludes ‘cost effective' |
Gift (2002)10 | Test for both chlamydia and gonorrhoea. Treat gonorrhoea positive for both diseases, and treat positive for just chlamydia | Primary care | USA | + | Static | −$130 to $557 cost per PID case avoided (2000 value) |
Gift et al (2005)11 | Range of interventions to increase repeat screening in patients treated for gonorrhoea or chlamydia (verbal recommendation, monetary incentive, reminder card, counselling, phone call, letter) | Sexually transmitted disease clinics | USA | + | Static | $224–$1620 cost per infection treated (2001 value) |
Ginnochio (2003)12 | LCR assay testing all young men | Primary care | USA | ++ | Static | $6 to $1738 cost per case prevented (2000 value) |
Howell et al (1997)13 | Partner notification of index male/female of pelvic inflammatory disease | Primary care | USA | + | Static | −$3900 to −$1700 (cost saving) per PID case avoided (1994 value) |
Howell et al (1998)14 | Screening of asymptomatic women based on CDC criteria | Family planning clinics | USA | + | Static | 64 PID cases prevented saving $213k; 26 prevented saving $74k; 6 prevented cost $19k (1995 values) |
Howell et al (1999)15 | Screening for chlamydia in female army recruits | Army | USA | + | Static | −$800 to $166 cost per PID case avoided (1995 value) |
Hu (2004)16 | No screening versus screening for all women | Primary care | USA | ++ | Static and dynamic | $2350 to $7490 cost per QALY (2000 value) |
Humphreys (1992)17 | Universal screening of women | Primary care | USA | – | Static | Not explicitly stated but concludes ‘cost effective' |
Kraut‐Becher et al (2004)18 | Screening for chlamydia and gonorrhoea | Jail | USA | + | Static | −$172 to 3690 per case of PID avoided (2002 value) |
Marrazzo et al (1997)19 | Universal screening | Family planning and STD clinics | USA | + | Static | −$1044 (cost saving) to $43 per case avoided (1993 value) |
Mehta et al (2002)20 | Screening for chlamydia and gonorrhoea | Emergency departments | USA | – | Static | −$437 (cost saving) to $1694 per case treated (1999 value) |
Mrus et al (2003)21 | Screening | Juvenile detention centres | USA | – | Static | $80 to $505 cost per infection treated (1998 value) |
Norman et al (2004)22 | Screening for chlamydia | Women attending antenatal, abortion, colposcopy and family planning clinics | Scotland | + | Static | £258 to £1196 cost per sequelae averted (2001 value) |
Paavonen et al (1998)23 | Screening of women | Unclear what group of women | Finland | – | Static | $50 cost per case without screen; $44 if 100% screened $47 if 50% (year unclear) |
Peeling et al (1998)24 | Screening of men | STI clinic | Canada | + | Static | CAN$453 cost per infected case (1990 value) |
Postma (2000)25 | Screening of sexually active women | General practice | the Netherlands | + | Static | −$35 (cost saving) to $2582 cost per major outcome averted (1996 value) |
Postma (2001)26 | Treatment of partners to females identified with chlamydia through opportunistic screening | Primary care | the Netherlands | + | Static | €132 to €781 cost per major outcome averted (1996 value) |
Sellors et al (1992)27 | Screening for chlamydia selectively versus universally | Family planning clinics | Canada | + | Static | CAN$28 to Can$9,864 cost per case detected (1989 value) |
Van Bergen (2004)28 | Pharmacy provision of tests to a high risk population, which are returned by post | Pharmacy setting | the Netherlands | + | Static | Cost saving to €3740 cost per PID case avoided (2001 value) |
Van V et al (2001)29 | Systematic screening of women on home‐based collection of urine | Primary care | the Netherlands | + | Static | $11 100 to $15 800 per major outcome averted (1996 value) |
Ward (2006)30 | Screening | Not explicit | Australia | + | Static | −AUS$56 (cost saving) to AUS$56 net benefit (2002 value) |
Welte et al (2000)31 | GP‐based screening | Primary care | the Netherlands | ++ | Dynamic | $492 per major outcome averted (1997 value) |
Welte et al (2005)32 | GP‐based screening | GP clinics | the Netherlands | ++ | Dynamic and static | Cost saving to $700 cost per major outcome averted (1997 value) |
CE, clinical evidence; GP, general practitioner; GUM, genito‐urinary medicine; NAAT, nucleic acid amplification test; Nkr, Norwegian Kronor; PID, pelvic inflammatory disease; STI, sexually transmitted infection.