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New point of care Chlamydia Rapid Test—bridging the gap between diagnosis and treatment: performance evaluation study

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39402.463854.AE (Published 06 December 2007) Cite this as: BMJ 2007;335:1190

Rapid Response:

Cost-effectiveness considerations for this test

I found the article quite interesting, but wonder at the test's
potential for widespread adoption. Its ease of use and lack of expensive
equipment make it very attractive. For this methodology to truly be cost-
effective, considerations must be given to target populations and current
treatment rates and time delays.

For example, in the state of Illinois the overall treatment rate for
women testing positive exceeds 90% for the past few years (unpublished
data). However, only ~80% of those are treated within 30 days (leading to
the referenced problem with the development of PID in the interim). I
wonder that the widespread, general adoption of this test as a complement
to the current methodologies would cost more than is saved by averted
morbidity? However, its use in selected situations, such as for women who
present to ER/ED for PID and are tested for chlamydia, might be quite
useful. Finding these individuals later for standard test results is much
more difficult than for those who present to a family planning clinic or
private physician. I do not know the cost of the test in the UK, nor the
local treatment rates, but I suspect that widespread adoption of this
test, done in conjunction with standardized PCR, would not be cost-
effective.

I would be quite interested in seeing further work done to determine
the best settings where this may be effectively applied.

Competing interests:
None declared

Competing interests: No competing interests

04 December 2007
Wiley D. Jenkins
Assistant Professor
Southern Illinois University School of Medicine, 913 N. Rutledge St, PO Box 19671, Springfield, IL 4