Table 2.
Test, cost per test; complications avoided by detection | Probability that complication is fatal | Disability weight (duration, years) | DALYs averted per abnormal laboratory test result detecteda | Cost of medical care averteda | References |
---|---|---|---|---|---|
SGOT/SGPT, $6.00 | |||||
Progression to severe hepatitis from tuberculosis drugsb | 0.047 | 0.209 (0.25) | 0.394 | $477.00 | [23–25] |
Creatinine, $3.00 | |||||
ART overdosage (ART doses lowered because of renal failure) | 0.000 | 0.086 (0.25) | 0.022 | $53.00 | [23, 26] |
Glucose, $3.00 | |||||
Blindness | 0.000 | 0.600 (4.2) | 0.136c | $360.00 | [23, 27] |
Renal failure | 0.086 (4.2) | 0.007c | |||
Amputation | 0.155 (4.2) | 0.013c | |||
CBC (hemoglobin, neutrophils, and platelets), $6.00 | |||||
Grade 3 anemia | 0.000 | 0.093 (1.0) | 0.090 | $43.00 | [6, 23, 28, 29] |
Grade 4 anemia | 0.009 | 0.255 (1.0) | 0.311 | $74.00 | |
Neutropenia | 0.028 | 0.000 (0.0) | 0.205 | $101.00 | |
Thrombocytopenia | 0.008 | 0.000 (0.0) | 0.059 | $75.00 | |
Hematocrit (spun), $0.33 | |||||
Grade 3 anemia | 0.000 | 0.093 (1.0) | 0.090 | $43.00 | [6, 23] |
Grade 4 anemia | 0.009 | 0.255 (1.0) | 0.311 | $74.00 |
NOTE. All dollar amounts are in US dollars. DALYs are calculated assuming life expectancy of 8.4 years [30]. ART, antiretroviral therapy; CBC, complete blood count; SGOT/SGPT, serum glutamic oxaloacetic transaminase/serum glutamic pyruvic transaminase.
For calculations of DALYs averted, see Table A1 in the Appendix (which appears only in the electronic version of the journal), and for calculations of medical costs averted by early detection, see Tables A2–A4 in the Appendix.
Note that ART-related liver disease did not result in any changes in medication.
Assumes 0.066 probability of blindness, 0.023 probability of renal failure, and 0.025 probability of amputation; total DALYs averted are 0.156 per case of diabetes detected.