A decision-analytic approach to postexposure rabies prophylaxis.
The risks and benefits of postexposure rabies prophylaxis were analyzed from clinical and economic perspectives. A decision-analytic model was constructed by using probability and outcome data from the literature and the state health department. Health outcomes were measured in quality-adjusted life years. In the base case (overweight adult male), treatment is optimal when the probability of animal rabidity is greater than 1 in 2000. Sensitivity analysis showed robustness in the treatment decision; however, the incremental cost-effectiveness ratio ($140,000/quality-adjusted life year) is sensitive to the rabidity probability. Treatment is optimal from the patient's perspective; however, it may not be cost-effective when the probability of rabidity is low.
Department of Family Medicine, University of Texas Medical Branch at Galveston 77555-0853.
S B
SB
Cantor
R D
RD
Clover
R F
RF
Thompson
D000818:Animals; D001499:Bayes Theorem; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003663:Decision Trees; D004199:Disease Vectors; D006801:Humans; D008297:Male; D009893:Opossums; D011336:Probability; D011788:Quality of Life; D011818:Rabies / Q000453:epidemiology / Q000628:therapy* / Q000635:transmission; D011819:Rabies Vaccines / Q000191:economics / Q000627:therapeutic use*; D012680:Sensitivity and Specificity
D011819:Rabies Vaccines