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Expert Rev Mol Diagn ; 15(1): 125-36, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25537569

ABSTRACT

OBJECTIVE: Point-of-care (POC) D-dimer tests have been developed to exclude deep venous thrombosis quickly and on the spot, but are known to have lower sensitivity compared with laboratory-based tests. Their cost-effectiveness is still unknown. METHODS: We updated and extended a previously published Markov model to assess the cost-effectiveness of POC D-dimer tests ('Simplify', 'Cardiac', 'Triage' and 'Nycocard') compared with a laboratory-based latex assay to diagnose deep venous thrombosis in primary care. RESULTS: The 'Laboratory' strategy resulted in 6.986 quality-adjusted life years at the cost of €8354 per patient. All POC D-dimer tests resulted in health outcomes similar to the 'Laboratory' strategy. The 'Simplify' strategy maximized cost savings (-€155 [95% CI: -€246 to -€83]). CONCLUSIONS: POC D-dimer tests yield similar health outcomes as laboratory-based testing procedures but can be performed more easily and at lower costs. Therefore, these tests are an alternative to laboratory-based testing and might be considered for exclusion of deep venous thrombosis in primary care.


Subject(s)
Point-of-Care Systems/economics , Venous Thrombosis/diagnosis , Cost-Benefit Analysis , Fibrin Fibrinogen Degradation Products/metabolism , Humans , Primary Health Care , Venous Thrombosis/blood
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