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Published in: Virology Journal 1/2011

Open Access 01-12-2011 | Research

Determination of the relative economic impact of different molecular-based laboratory algorithms for respiratory viral pathogen detection, including Pandemic (H1N1), using a secure web based platform

Authors: Bonita E Lee, Shamir N Mukhi, Jennifer May-Hadford, Sabrina Plitt, Marie Louie, Steven J Drews

Published in: Virology Journal | Issue 1/2011

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Abstract

Background

During period of crisis, laboratory planners may be faced with a need to make operational and clinical decisions in the face of limited information. To avoid this dilemma, our laboratory utilizes a secure web based platform, Data Integration for Alberta Laboratories (DIAL) to make near real-time decisions.
This manuscript utilizes the data collected by DIAL as well as laboratory test cost modeling to identify the relative economic impact of four proposed scenarios of testing for Pandemic H1N1 (2009) and other respiratory viral pathogens.

Methods

Historical data was collected from the two waves of the pandemic using DIAL. Four proposed molecular testing scenarios were generated: A) Luminex respiratory virus panel (RVP) first with/without US centers for Disease Control Influenza A Matrix gene assay (CDC-M), B) CDC-M first with/without RVP, C) RVP only, and D) CDC-M only. Relative cost estimates of different testing algorithm were generated from a review of historical costs in the lab and were based on 2009 Canadian dollars.

Results

Scenarios A and B had similar costs when the rate of influenza A was low (< 10%) with higher relative cost in Scenario A with increasing incidence. Scenario A provided more information about mixed respiratory virus infection as compared with Scenario B.

Conclusions

No one approach is applicable to all conditions. Testing costs will vary depending on the test volume, prevalence of influenza A strains, as well as other circulating viruses and a more costly algorithm involving a combination of different tests may be chosen to ensure that tests results are returned to the clinician in a quicker manner. Costing should not be the only consideration for determination of laboratory algorithms.
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Literature
2.
go back to reference Drews SJ, Majury A, Jamieson F, Riley G, Mazzulli T, Low DE: Decentralized molecular diagnostic testing plan for pandemic influenza in the Ontario Public Health Laboratory system. Can J Public Health 2008, 99: 387-390.PubMed Drews SJ, Majury A, Jamieson F, Riley G, Mazzulli T, Low DE: Decentralized molecular diagnostic testing plan for pandemic influenza in the Ontario Public Health Laboratory system. Can J Public Health 2008, 99: 387-390.PubMed
3.
go back to reference Hatchette TF, Bastien N, Berry J, Booth TF, Chernesky M, Couillard M, Drews S, Ebsworth A, Fearon M, Fonseca K, et al.: The limitations of point of care testing for pandemic influenza: what clinicians and public health professionals need to know. Can J Public Health 2009, 100: 204-207.PubMed Hatchette TF, Bastien N, Berry J, Booth TF, Chernesky M, Couillard M, Drews S, Ebsworth A, Fearon M, Fonseca K, et al.: The limitations of point of care testing for pandemic influenza: what clinicians and public health professionals need to know. Can J Public Health 2009, 100: 204-207.PubMed
4.
go back to reference Mahony JB, Hatchette T, Ojkic D, Drews SJ, Gubbay J, Low DE, Petric M, Tang P, Chong S, Luinstra K, et al.: Multiplex PCR tests sentinel the appearance of pandemic influenza viruses including H1N1 swine influenza. J Clin Virol 2009, 45: 200-202. 10.1016/j.jcv.2009.05.031CrossRefPubMed Mahony JB, Hatchette T, Ojkic D, Drews SJ, Gubbay J, Low DE, Petric M, Tang P, Chong S, Luinstra K, et al.: Multiplex PCR tests sentinel the appearance of pandemic influenza viruses including H1N1 swine influenza. J Clin Virol 2009, 45: 200-202. 10.1016/j.jcv.2009.05.031CrossRefPubMed
5.
go back to reference Pabbaraju K, Wong S, Wong AA, Appleyard GD, Chui L, Pang XL, Yanow SK, Fonseca K, Lee BE, Fox JD, et al.: Design and validation of real-time reverse transcription-PCR assays for detection of pandemic (H1N1) 2009 virus. J Clin Microbiol 2009, 47: 3454-3460. 10.1128/JCM.01103-09PubMedCentralCrossRefPubMed Pabbaraju K, Wong S, Wong AA, Appleyard GD, Chui L, Pang XL, Yanow SK, Fonseca K, Lee BE, Fox JD, et al.: Design and validation of real-time reverse transcription-PCR assays for detection of pandemic (H1N1) 2009 virus. J Clin Microbiol 2009, 47: 3454-3460. 10.1128/JCM.01103-09PubMedCentralCrossRefPubMed
7.
go back to reference Mukhi S, May-Hadford J, Plitt S, Preiksaitis JK, Lee BE: DIAL: A platform for real-time laboratory surveillance. Online Journal of Public Health Informatatics 2010., 3: Mukhi S, May-Hadford J, Plitt S, Preiksaitis JK, Lee BE: DIAL: A platform for real-time laboratory surveillance. Online Journal of Public Health Informatatics 2010., 3:
8.
go back to reference Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM: Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009, 360: 2605-2615.CrossRefPubMed Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM: Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 2009, 360: 2605-2615.CrossRefPubMed
9.
go back to reference Pabbaraju K, Tokaryk KL, Wong S, Fox JD: Comparison of the Luminex xTAG respiratory viral panel with in-house nucleic acid amplification tests for diagnosis of respiratory virus infections. J Clin Microbiol 2008, 46: 3056-3062. 10.1128/JCM.00878-08PubMedCentralCrossRefPubMed Pabbaraju K, Tokaryk KL, Wong S, Fox JD: Comparison of the Luminex xTAG respiratory viral panel with in-house nucleic acid amplification tests for diagnosis of respiratory virus infections. J Clin Microbiol 2008, 46: 3056-3062. 10.1128/JCM.00878-08PubMedCentralCrossRefPubMed
10.
go back to reference Pabbaraju K, Wong S, Lee B, Tellier R, Fonseca K, Louie M, Drews SJ: Comparison of a singleplex real-time RT-PCR assay and multiplex respiratory viral panel assay for detection of influenza "A" in respiratory specimens. Influenza Other Respi Viruses 2011, 5: 99-103. 10.1111/j.1750-2659.2010.00170.xCrossRef Pabbaraju K, Wong S, Lee B, Tellier R, Fonseca K, Louie M, Drews SJ: Comparison of a singleplex real-time RT-PCR assay and multiplex respiratory viral panel assay for detection of influenza "A" in respiratory specimens. Influenza Other Respi Viruses 2011, 5: 99-103. 10.1111/j.1750-2659.2010.00170.xCrossRef
11.
go back to reference Adcock PM, Stout GG, Hauck MA, Marshall GS: Effect of rapid viral diagnosis on the management of children hospitalized with lower respiratory tract infection. Pediatr Infect Dis J 1997, 16: 842-846. 10.1097/00006454-199709000-00005CrossRefPubMed Adcock PM, Stout GG, Hauck MA, Marshall GS: Effect of rapid viral diagnosis on the management of children hospitalized with lower respiratory tract infection. Pediatr Infect Dis J 1997, 16: 842-846. 10.1097/00006454-199709000-00005CrossRefPubMed
12.
go back to reference Oosterheert JJ, van Loon AM, Schuurman R, Hoepelman AI, Hak E, Thijsen S, Nossent G, Schneider MM, Hustinx WM, Bonten MJ: Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection. Clin Infect Dis 2005, 41: 1438-1444. 10.1086/497134CrossRefPubMed Oosterheert JJ, van Loon AM, Schuurman R, Hoepelman AI, Hak E, Thijsen S, Nossent G, Schneider MM, Hustinx WM, Bonten MJ: Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection. Clin Infect Dis 2005, 41: 1438-1444. 10.1086/497134CrossRefPubMed
13.
go back to reference Fox JD: Respiratory virus surveillance and outbreak investigation. J Clin Virol 2007,40(Suppl 1):S24-S30.CrossRefPubMed Fox JD: Respiratory virus surveillance and outbreak investigation. J Clin Virol 2007,40(Suppl 1):S24-S30.CrossRefPubMed
14.
go back to reference Nichols WG, Peck Campbell AJ, Boeckh M: Respiratory viruses other than influenza virus: impact and therapeutic advances. Clin Microbiol Rev 2008, 21: 274-90. table 10.1128/CMR.00045-07PubMedCentralCrossRefPubMed Nichols WG, Peck Campbell AJ, Boeckh M: Respiratory viruses other than influenza virus: impact and therapeutic advances. Clin Microbiol Rev 2008, 21: 274-90. table 10.1128/CMR.00045-07PubMedCentralCrossRefPubMed
15.
go back to reference Woo PC, ChiuS S, Seto WH, Peiris M: Cost-effectiveness of rapid diagnosis of viral respiratory tract infections in pediatric patients. J Clin Microbiol 1997, 35: 1579-1581.PubMedCentralPubMed Woo PC, ChiuS S, Seto WH, Peiris M: Cost-effectiveness of rapid diagnosis of viral respiratory tract infections in pediatric patients. J Clin Microbiol 1997, 35: 1579-1581.PubMedCentralPubMed
16.
go back to reference Barenfanger J, Drake C, Leon N, Mueller T, Troutt T: Clinical and financial benefits of rapid detection of respiratory viruses: an outcomes study. J Clin Microbiol 2000, 38: 2824-2828.PubMedCentralPubMed Barenfanger J, Drake C, Leon N, Mueller T, Troutt T: Clinical and financial benefits of rapid detection of respiratory viruses: an outcomes study. J Clin Microbiol 2000, 38: 2824-2828.PubMedCentralPubMed
17.
go back to reference Rocholl C, Gerber K, Daly J, Pavia AT, Byington CL: Adenoviral infections in children: the impact of rapid diagnosis. Pediatrics 2004, 113: e51-e56. 10.1542/peds.113.1.e51CrossRefPubMed Rocholl C, Gerber K, Daly J, Pavia AT, Byington CL: Adenoviral infections in children: the impact of rapid diagnosis. Pediatrics 2004, 113: e51-e56. 10.1542/peds.113.1.e51CrossRefPubMed
18.
go back to reference Doherty JA, Brookfield DS, Gray J, McEwan RA: Cohorting of infants with respiratory syncytial virus. J Hosp Infect 1998, 38: 203-206. 10.1016/S0195-6701(98)90275-4CrossRefPubMed Doherty JA, Brookfield DS, Gray J, McEwan RA: Cohorting of infants with respiratory syncytial virus. J Hosp Infect 1998, 38: 203-206. 10.1016/S0195-6701(98)90275-4CrossRefPubMed
19.
go back to reference Ruest A, Michaud S, Deslandes S, Frost EH: Comparison of the Directigen flu A+B test, the QuickVue influenza test, and clinical case definition to viral culture and reverse transcription-PCR for rapid diagnosis of influenza virus infection. J Clin Microbiol 2003, 41: 3487-3493. 10.1128/JCM.41.8.3487-3493.2003PubMedCentralCrossRefPubMed Ruest A, Michaud S, Deslandes S, Frost EH: Comparison of the Directigen flu A+B test, the QuickVue influenza test, and clinical case definition to viral culture and reverse transcription-PCR for rapid diagnosis of influenza virus infection. J Clin Microbiol 2003, 41: 3487-3493. 10.1128/JCM.41.8.3487-3493.2003PubMedCentralCrossRefPubMed
20.
go back to reference Ong GM, Wyatt DE, O'Neill HJ, McCaughey C, Coyle PV: A comparison of nested polymerase chain reaction and immunofluorescence for the diagnosis of respiratory infections in children with bronchiolitis, and the implications for a cohorting strategy. J Hosp Infect 2001, 49: 122-128. 10.1053/jhin.2001.1044CrossRefPubMed Ong GM, Wyatt DE, O'Neill HJ, McCaughey C, Coyle PV: A comparison of nested polymerase chain reaction and immunofluorescence for the diagnosis of respiratory infections in children with bronchiolitis, and the implications for a cohorting strategy. J Hosp Infect 2001, 49: 122-128. 10.1053/jhin.2001.1044CrossRefPubMed
21.
go back to reference Ieven M: Currently used nucleic acid amplification tests for the detection of viruses and atypicals in acute respiratory infections. J Clin Virol 2007, 40: 259-276. 10.1016/j.jcv.2007.08.012CrossRefPubMed Ieven M: Currently used nucleic acid amplification tests for the detection of viruses and atypicals in acute respiratory infections. J Clin Virol 2007, 40: 259-276. 10.1016/j.jcv.2007.08.012CrossRefPubMed
22.
go back to reference Nicoll A, Ammon A, Amato GA, Ciancio B, Zucs P, Devaux I, Plata F, Mazick A, Molbak K, Asikainen T, et al.: Experience and lessons from surveillance and studies of the 2009 pandemic in Europe. Public Health 2010, 124: 14-23. 10.1016/j.puhe.2009.12.001CrossRefPubMed Nicoll A, Ammon A, Amato GA, Ciancio B, Zucs P, Devaux I, Plata F, Mazick A, Molbak K, Asikainen T, et al.: Experience and lessons from surveillance and studies of the 2009 pandemic in Europe. Public Health 2010, 124: 14-23. 10.1016/j.puhe.2009.12.001CrossRefPubMed
23.
go back to reference Vongphrachanh P, Simmerman JM, Phonekeo D, Pansayavong V, Sisouk T, Ongkhamme S, Bryce GT, Corwin A, Bryant JE: An early report from newly established laboratory-based influenza surveillance in Lao PDR. Influenza Other Respi Viruses 2010, 4: 47-52. 10.1111/j.1750-2659.2009.00120.xCrossRef Vongphrachanh P, Simmerman JM, Phonekeo D, Pansayavong V, Sisouk T, Ongkhamme S, Bryce GT, Corwin A, Bryant JE: An early report from newly established laboratory-based influenza surveillance in Lao PDR. Influenza Other Respi Viruses 2010, 4: 47-52. 10.1111/j.1750-2659.2009.00120.xCrossRef
25.
go back to reference Bradt DA, Epstein J: The rational clinician in a pandemic setting. Med J Aust 2010, 192: 87-89.PubMed Bradt DA, Epstein J: The rational clinician in a pandemic setting. Med J Aust 2010, 192: 87-89.PubMed
26.
go back to reference Paneth-Pollak R, Schillinger JA, Borrelli JM, Handel S, Pathela P, Blank AS: Using STD electronic medical record data to drive public health program decisions in New York City. Am J Public Health 2010, 100: 586-590. 10.2105/AJPH.2009.175349PubMedCentralCrossRefPubMed Paneth-Pollak R, Schillinger JA, Borrelli JM, Handel S, Pathela P, Blank AS: Using STD electronic medical record data to drive public health program decisions in New York City. Am J Public Health 2010, 100: 586-590. 10.2105/AJPH.2009.175349PubMedCentralCrossRefPubMed
27.
go back to reference McCaughey D, Bruning NS: Rationality versus reality: the challenges of evidence-based decision making for health policy makers. Implement Sci 2010, 5: 39. 10.1186/1748-5908-5-39PubMedCentralCrossRefPubMed McCaughey D, Bruning NS: Rationality versus reality: the challenges of evidence-based decision making for health policy makers. Implement Sci 2010, 5: 39. 10.1186/1748-5908-5-39PubMedCentralCrossRefPubMed
Metadata
Title
Determination of the relative economic impact of different molecular-based laboratory algorithms for respiratory viral pathogen detection, including Pandemic (H1N1), using a secure web based platform
Authors
Bonita E Lee
Shamir N Mukhi
Jennifer May-Hadford
Sabrina Plitt
Marie Louie
Steven J Drews
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Virology Journal / Issue 1/2011
Electronic ISSN: 1743-422X
DOI
https://doi.org/10.1186/1743-422X-8-277

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