Table 4. Univariate sensitivity analysis of the comparison of diagnostic strategies for Latent Tuberculosis Infection in relation to TST≥10 mm strategy, considering as outcome measure the number of individuals correctly classified and the number of active tuberculosis cases averted by the diagnostic tests for Latent Tuberculosis Infection.
Diagnostic Strategies | Total Cost (US$) | Incremental Cost (US$) | Effectiveness | Incremental Effectiveness | ICER (US$) |
---|---|---|---|---|---|
Number of individuals correctly classified by the tests | |||||
Base Case | |||||
TST≥10 mm | 30,084.47 | _ | 6,395 | _ | _ |
TST≥5 mm | 30,471.02 | 386.55 | 6,704 | 309 | 1.25 |
TST≥5 mm/QFT-GIT | 46,897.44 | 16,426.42 | 8,222 | 1,518 | 10.82 |
TST≥10 mm/QFT-GIT | 47,376.73 | 479.29 | 8,069 | -153 | dominated |
QFT-GIT | 160,531.88 | 113,155.15 | 9 | 931 | 121.54 |
TST sensitivity with ≥10 mm cut-off point = 55% | |||||
TST ≥10 mm | 27,132.40 | _ | 5,545 | _ | _ |
TST ≥5 mm | 30,471.01 | 3,338.61 | 6,704 | 1,159 | 2.88 |
TST ≥10 mm/QFT-GIT | 42,753.92 | 12,282.91 | 7,406 | 702 | 17.49 |
TST ≥5 mm/QFT-GIT | 46,897.44 | 4,143.52 | 8,222 | 816 | 5.07 |
QFT-GIT | 160,531.88 | 113,634.44 | 9 | 778 | 146.05 |
TST sensitivity with ≥10 mm cut-off point = 95% | |||||
TST ≥5 mm | 30,471.01 | _ | 6,704 | _ | _ |
TST≥10 mm | 34,028.57 | 3,557.56 | 7,09 | 386 | 9.21 |
TST ≥5 mm/QFT-GIT | 46,897.44 | 12,868.87 | 8,222 | 1,132 | 11.36 |
TST ≥10 mm/QFT-GIT | 53,097.51 | 6,200.07 | 8,612 | 390 | 15.89 |
QFT-GIT | 160,531.88 | 107,434.37 | 9 | 388 | 276.89 |
TST sensitivity with ≥5 mm cut-off point = 68% | |||||
TST ≥5 mm | 28,057.35 | _ | 6,163 | _ | _ |
TST ≥10 mm | 30,084.47 | 2,027.12 | 6,395 | 232 | 8.73 |
TST ≥5 mm/QFT-GIT | 43,278.68 | 13,194.21 | 7,8 | 1,405 | 9.39 |
TST ≥10 mm/QFT-GIT | 47,376.73 | 4,098.05 | 8,069 | 269 | 15.23 |
QFT-GIT | 160,531.88 | 113,155.15 | 9 | 931 | 121.54 |
TST sensitivity with ≥5 mm cut-off point = 97% | |||||
TST ≥10 mm | 30,084.47 | _ | 6,395 | _ | _ |
TST ≥5 mm | 33,980.72 | 3,896.25 | 7,284 | 889 | 4.38 |
TST ≥10 mm/QFT-GIT | 47,376.73 | 13,396.01 | 8,069 | 785 | 17.06 |
TST ≥5 mm/QFT-GIT | 51,947.96 | 4,571.23 | 8,674 | 605 | 7.55 |
QFT-GIT | 160,531.88 | 108,583.92 | 9 | 326 | 333,07 |
Number of cases of active tuberculosis avoided | |||||
Base Case | |||||
TST ≥10 mm | 30,084.47 | _ | 3,881 | _ | _ |
TST ≥5 mm | 30,471.02 | 386.55 | 3,886 | 5 | 77.31 |
TST ≥5 mm/QFT-GIT | 46,897.44 | 16,426.42 | 3,869 | -17 | dominated |
TST ≥10 mm/QFT-GIT | 47,376.73 | 479.29 | 3,865 | -4 | dominated |
QFT-GIT | 160,531.88 | 113,155.15 | 3,884 | 19 | 5,955.53 |
TST sensitivity with ≥10 mm cut-off point = 55% | |||||
TST ≥10 mm | 27,132.40 | _ | 3,86 | _ | _ |
TST ≥5 mm | 30,471.01 | 3,338.61 | 3,886 | 26 | 128.40 |
TST ≥10 mm/QFT-GIT | 42,758.17 | 12,287.16 | 3,849 | -37 | dominated |
TST ≥5 mm/QFT-GIT | 46,897.44 | 4,139.27 | 3,869 | 20 | 206.96 |
QFT-GIT | 160,531.88 | 113,634.44 | 3,884 | 15 | 7,575.62 |
TST sensitivity with ≥10 mm cut-off point = 95% | |||||
TST ≥5 mm | 30,471.01 | _ | 3,886 | _ | _ |
TST ≥10 mm | 34,028.57 | 3,557.56 | 3,898 | 12 | 296.46 |
TST ≥5 mm/QFT-GIT | 46,897.44 | 12,868.87 | 3,869 | -29 | dominated |
TST ≥10 mm/QFT-GIT | 53,097.51 | 6,200.07 | 3,878 | 9 | 688.89 |
QFT-GIT | 160,531.88 | 107,434.37 | 3,884 | 6 | 17,905.72 |
TST sensitivity with ≥5 mm cut-off point = 68% | |||||
TST ≥5 mm | 28,057.35 | _ | 3,872 | _ | _ |
TST ≥10 mm | 30,084.47 | 2,027.12 | 3,881 | 9 | 225.23 |
TST ≥5 mm/QFT-GIT | 43,278.67 | 13,194.20 | 3,858 | -23 | dominated |
TST ≥10 mm/QFT-GIT | 47,376.73 | 4,098.06 | 3,865 | 7 | 585.43 |
QFT-GIT | 160,531.88 | 113,155.15 | 3,884 | 19 | 5,955.53 |
TST sensitivity with ≥5 mm cut-off point = 97% | |||||
TST ≥10 mm | 30,084.47 | _ | 3,881 | _ | _ |
TST ≥5 mm | 33.980.72 | 3,896.25 | 3,9 | 19 | 205.06 |
TST ≥10 mm/QFT-GIT | 47,376.73 | 13,396.01 | 3,865 | -35 | dominated |
TST ≥5mm/QFT-GIT | 51,947.96 | 4,571.23 | 3,88 | 15 | 304.74 |
QFT-GIT | 160,531.88 | 108,583.92 | 3,884 | 4 | 27,145.98 |
TST specificity with ≥10 mm cut-off point = 43% | |||||
TST ≥5 mm | 30,471.01 | _ | 3,886 | _ | _ |
TST ≥10 mm | 37,527.68 | 7,056.67 | 3,881 | -5 | dominated |
TST ≥5 mm/QFT-GIT | 46,897.44 | 9,369.76 | 3,869 | -12 | dominated |
TST ≥10 mm/QFT-GIT | 67,776.09 | 20,878.65 | 3,865 | -4 | dominated |
QFT-GIT | 160,531.88 | 92,755.79 | 3,884 | 19 | 4,881.88 |
TST specificity with ≥10 mm cut-off point = 73% | |||||
TST ≥10 mm | 27,764.41 | _ | 3,881 | _ | _ |
TST ≥5 mm | 30,471.01 | 2,706.60 | 3,886 | 5 | 541.32 |
TST ≥10 mm/QFT-GIT | 37,190.45 | 6,719.44 | 3,865 | -21 | dominated |
TST ≥5 mm/QFT-GIT | 46,897.44 | 9,706.99 | 3,869 | 4 | 2,426.74 |
QFT-GIT | 160,531.88 | 113,634.44 | 3,884 | 15 | 7,575.62 |
TST specificity with ≥5 mm cut-off point = 35% | |||||
TST≥10 mm | 30,084.47 | - | 3,881 | 0 | - |
TST≥5 mm | 44,123.57 | 14,039.09 | 3,886 | 5 | 2,807.82 |
TST≥10 mm/QFT-GIT | 47,376.73 | 3,253.17 | 3,865 | -21 | dominated |
TST≥5 mm/QFT-GIT | 82,892.72 | 38,769.16 | 3,869 | -17 | dominated |
QFT-GIT | 160,531.90 | 116,408.30 | 3,884 | -2 | dominated |
TST specificity with ≥5 mm cut-off point = 79% | |||||
TST≥5 mm | 28,925.61 | - | 3,886 | 0 | _ |
TST≥10 mm | 30,084.47 | 1,158.86 | 3,881 | -5 | dominated |
TST≥5 mm/QFT-GIT | 36,428.17 | 7,502.55 | 3,869 | -17 | dominated |
TST≥10 mm/QFT-GIT | 47,376.73 | 18,451.12 | 3,865 | -21 | dominated |
QFT-GIT | 160,531.90 | 131,606.30 | 3,884 | -2 | dominated |
Caption: ICER–Incremental Cost-Effectiveness Ratio; LTBI–Latent Tuberculosis Infection; QFT-GIT–QuantiFERON-TB Gold In-Tube; TST–Tuberculosis Skin Test.