Cost-benefit analysis of first-void urine Chlamydia trachomatis screening program.
OBJECTIVE
To perform a cost-benefit analysis of a Chlamydia trachomatis screening program based on first-void urine testing of asymptomatic women using a polymerase chain reaction (PCR) test.


METHODS
A decision tree was developed. Selected variables based on assumptions were subjected to sensitivity analyses to make the model accurate and defensible.


RESULTS
Screening for chlamydial infections using the PCR test was shown to be cost-effective even in low-prevalence populations. Compared with a symptom-driven no-screening situation, a universal C trachomatis screening program using the PCR test would save money, in terms of direct cost, when the baseline prevalence of C trachomatis infection exceeds 3.9%.


CONCLUSIONS
Cost analyses are still rare among trials that compare pharmacologic or procedural health care interventions. Socioeconomic studies linking secondary prevention of C trachomatis infection and infertility and adverse pregnancy outcome are needed to convince public health authorities of the need for and the benefit of such programs.
Department of Obstetrics and Gynecology and the Haartman Institute, University of Helsinki, Finland. jpaavone@cc.helsinki.fi
J
J
Paavonen
M
M
Puolakkainen
M
M
Paukku
H
H
Sintonen
D000293:Adolescent; D000328:Adult; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D014556:Urine / Q000382:microbiology*