title: The cost-effectiveness of school-based eating disorder screening.
abstract: OBJECTIVE
  We aimed to assess the value of school-based eating disorder (ED) screening for a hypothetical cohort of US public school students.
  
  
  METHODS
  We used a decision-analytic microsimulation model to model the effectiveness (life-years with ED and quality-adjusted life-years [QALYs]), total direct costs, and cost-effectiveness (cost per QALY gained) of screening relative to current practice.
  
  
  RESULTS
  The screening strategy cost $2260 (95% confidence interval [CI] = $1892, $2668) per student and resulted in a per capita gain of 0.25 fewer life-years with ED (95% CI = 0.21, 0.30) and 0.04 QALYs (95% CI = 0.03, 0.05) relative to current practice. The base case cost-effectiveness of the intervention was $9041 per life-year with ED avoided (95% CI = $6617, $12,344) and $56,500 per QALY gained (95% CI = $38,805, $71,250).
  
  
  CONCLUSIONS
  At willingness-to-pay thresholds of $50,000 and $100,000 per QALY gained, school-based ED screening is 41% and 100% likely to be cost-effective, respectively. The cost-effectiveness of ED screening is comparable to many other accepted pediatric health interventions, including hypertension screening.
authors.affiliation: Davene R. Wright is with the Department of Pediatrics, University of Washington School of Medicine, and the Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle. S. Bryn Austin is with the Department of Social and Behavioral Sciences, Harvard School of Public Health, and the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston. Kendrin R. Sonneville is with the Department of Pediatrics, Harvard Medical School, and the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston. H. LeAnn Noh is with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston. Yushan Jiang is with the Department of Global Health and Population, Harvard School of Public Health, Boston.
authors.forename: Davene R
authors.initials: DR
authors.lastname: Wright
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
authors.forename: H
authors.initials: H
authors.lastname: LeAnn Noh
authors.forename: Yushan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Kendrin R
authors.initials: KR
authors.lastname: Sonneville
mesh_terms: D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D001068:Feeding and Eating Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D018803:Models, Economic; D019057:Quality-Adjusted Life Years