Evidence map›Paper›PMID 38356377›Full record

ArticleInfection control and hospital epidemiology2024

Cost-effectiveness of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) testing and isolation strategies in nursing homes.

Sarah M Bartsch, Colleen Weatherwax, Marie F Martinez, Kevin L Chin, Michael R Wasserman, Raveena D Singh, Jessie L Heneghan, Gabrielle M Gussin, Sheryl A Scannell, Cameron White and 3 more

Abstract read
In one paragraph

Article in Infection control and hospital epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Sarah M BartschCenter for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York.
Colleen WeatherwaxCenter for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York.ORCID 0000-0001-5929-518X
Marie F MartinezCenter for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York.
Kevin L ChinCenter for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York.
Michael R WassermanLos Angeles Jewish Home, Reseda, California.
Raveena D SinghDivision of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California.
Jessie L HeneghanCenter for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York.ORCID 0009-0007-5274-9864
Gabrielle M GussinDivision of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California.ORCID 0000-0001-8051-7613
Sheryl A ScannellCenter for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York.ORCID 0000-0003-2784-6279
Cameron WhiteCenter for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York.
Bruce LeffCenter for Transformative Geriatric Research, Division of Geriatric Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Susan S Huang *Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California.ORCID 0000-0001-6748-3447
Bruce Y Lee *Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York City, New York.ORCID 0000-0003-2633-8651

Funding

Project 4: Virtual Public Health Precision Nutrition LaboratoryU54TR004279 · NCATS · GRADUATE SCHOOL OF PUBLIC HEALTH AND HEALTH POLICY · PI Bruce Y Lee · 2022 to 2026
$5.4M
Regional Healthcare Ecosystem Analyst for Healthcare Associated InfectionsR01HS023317 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI LEE, BRUCE Y · 2014 to 2014
$2.4M
Regional Healthcare Ecosystem Analyst (RHEA) Modeling the Environment (MODE): SARS-CoV-2R01GM127512 · NIGMS · GRADUATE SCHOOL OF PUBLIC HEALTH AND HEALTH POLICY · PI LEE, BRUCE Y · 2020 to 2023
$2.1M
MOdeling Nursing homes to Affect Response to COVID-19 (MONARC)R01HS028165 · AHRQ · GRADUATE SCHOOL OF PUBLIC HEALTH AND HEALTH POLICY · PI LEE, BRUCE Y · 2021 to 2022
$993k
AHRQ HHS R01 HS023317AHRQ HHS R01 HS028165NCATS NIH HHS U54 TR004279NIGMS NIH HHS R01 GM127512
6 · The paper itself

Abstract

objectiveNursing home residents may be particularly vulnerable to coronavirus disease 2019 (COVID-19). Therefore, a question is when and how often nursing homes should test staff for COVID-19 and how this may change as severe acute respiratory coronavirus virus 2 (SARS-CoV-2) evolves.

designWe developed an agent-based model representing a typical nursing home, COVID-19 spread, and its health and economic outcomes to determine the clinical and economic value of various screening and isolation strategies and how it may change under various circumstances.

resultsUnder winter 2023-2024 SARS-CoV-2 omicron variant conditions, symptom-based antigen testing averted 4.5 COVID-19 cases compared to no testing, saving $191 in direct medical costs. Testing implementation costs far outweighed these savings, resulting in net costs of $990 from the Centers for Medicare & Medicaid Services perspective, $1,545 from the third-party payer perspective, and $57,155 from the societal perspective. Testing did not return sufficient positive health effects to make it cost-effective [$50,000 per quality-adjusted life-year (QALY) threshold], but it exceeded this threshold in ≥59% of simulation trials. Testing remained cost-ineffective when routinely testing staff and varying face mask compliance, vaccine efficacy, and booster coverage. However, all antigen testing strategies became cost-effective (≤$31,906 per QALY) or cost saving (saving ≤$18,372) when the severe outcome risk was ≥3 times higher than that of current omicron variants.

conclusionsSARS-CoV-2 testing costs outweighed benefits under winter 2023-2024 conditions; however, testing became cost-effective with increasingly severe clinical outcomes. Cost-effectiveness can change as the epidemic evolves because it depends on clinical severity and other intervention use. Thus, nursing home administrators and policy makers should monitor and evaluate viral virulence and other interventions over time.

Indexed as

Cost-Benefit AnalysisCOVID-19COVID-19 TestingNursing HomesSARS-CoV-2HumansUnited States

Identifiers

PMID38356377
PMCPMC11102288

What Socratic holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.