From: Cost-effectiveness of tuberculosis evaluation and treatment of newly-arrived immigrants
 | Beginning with ... | Choose between ... | Best choice |
---|---|---|---|
1. | Treat only active cases; detect them only passively | (1) Offer LTBI treatment to TB2s or TB4s, or (2) send letters to improve evalua tion | Send letters (2.7 QALYs gained, $10 000 in net sav ings) |
2. | Send letters; treat active cases | (1) Offer LTBI treatment to TB2s, (2) Offer LTBI treatment to TB4s, or (3) make phone calls to improve evaluation rates | Treat TB4s (3.2 QALYs gained, $11 000 in net savings) |
3. | Treat active cases and TB4s; improve evaluation by letters | (1) Offer LTBI treatment to TB2s, (2) make phone calls to improve evaluation rates further, (3) improve rates of starting ther apy for TB4s, or (4) improve completion rates by DOPT | Improve starting rates (1.3 QALYs saved, $1 800 in net savings) |
4. | Treat active cases and TB4s; improve evaluation rates by letters; improve starting rates | (1) send letters to improve evalua tion rates further, (2) treat TB2s, or (3) improve completion rates by DOPT | Treat TB2s (0.7 QALYs saved, $3 000 in net cost) |
5. | Treat active cases, TB2s, and TB4s; improve evaluation by letters; improve rates of starting therapy | (1) Further improve evaluation rates by phone calls, or (2) improve rates of completing therapy (by targeted DOPT) | Phone calls (0.5 QALYs saved, approximately $1 000 in net savings) |
6. | Treat active cases, TB4s, and TB2s; improve evaluation by letters and phone calls | (1) Further improve evaluation rates by home visits, or (2) improve rates of completing therapy by using targeted DOPT | Home visits (0.3 QALYs saved, approximately $1 000 in net cost) |
7. | Treat active cases, TB4s, and TB2s; improve evaluation by letters and phone calls | (1) improve rates of completing therapy by using targeted DOPT | > $100 000 per QALY saved; no further intervention |