title: Central laboratory versus point of care testing in intraoperative monitoring of parathyroid hormone levels: cost comparison.
abstract: OBJECTIVE
  To examine the cost of central laboratory-based intraoperative parathyroid hormone (PTH) during parathyroid surgery compared with a point of care-based PTH testing system.
  
  
  METHODS
  Based on a retrospective analysis of intraoperative PTH testing in 50 parathyroid surgeries, a cost comparison between the current testing system at a university-affiliated tertiary care facility (Elecsys 1010, Roche Diagnostics, Basel, Switzerland) and a theoretical model using the QuiCK-intraoperative intact PTH system (Nichols Institute Diagnostics, San Juan Capistrano, CA) was generated.
  
  
  RESULTS
  The cost per surgery of central laboratory-based PTH testing was $129.15 compared with $550.98 for the point of care-based system. Costs were calculated accounting for the purchase price of equipment, cost of reagents and processing, and laboratory technician time.
  
  
  CONCLUSIONS
  This is the first cost comparison study using a Canadian-based health care model for point of care versus central laboratory PTH testing and adds to a very limited number of cost comparison studies on this topic. This study provides evidence that in the setting of a tertiary care facility that has on-site laboratory facilities with dedicated staff, central laboratory-based PTH assays provide an efficient and cost-effective way of monitoring PTH levels during parathyroidectomy surgery.
authors.affiliation: Division of Otolaryngology, University of Alberta, Edmonton, Alberta.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: O'Connell
authors.forename: Hadi
authors.initials: H
authors.lastname: Seikaly
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Harris
mesh_terms: D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood* / Q000191:economics / Q000601:surgery; D007432:Intraoperative Period; D007755:Laboratories, Hospital / Q000191:economics*; D008954:Models, Biological; D010281:Parathyroid Hormone / Q000097:blood*; D016105:Parathyroidectomy / Q000191:economics*; D019095:Point-of-Care Systems / Q000191:economics*; D012189:Retrospective Studies
chemical_list: D010281:Parathyroid Hormone