Serum and 24-hour urinary tests cost-effectiveness in stone formers

BMC Urology

Research

Hiro Farabi¹  Leonardo Oliveira Reis²  Behzad Narouie³  Leila Zareian Baghdadabad⁴  Seyed Mohammad Kazem Aghamir⁴  Abdolreza Mohammadi⁴ 

[1] Centre for Evaluation and Methods, Wolfson Institute of Population Health, Barts the London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, London, UK;Department of Urology, UroScience, Unicamp and Pontifical, State University of Campinas, Catholic University of Campinas, PUC-Campinas, Campinas, Brazil;Department of Urology, Zahedan University of Medical Sciences, Zahedan, Iran;Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran;

关键词: Urolithiasis;    Metabolic evaluation;    Recurrent kidney stone;    24-hour urinary test;    Cost-effectiveness;   

DOI  :  10.1186/s12894-023-01310-w

 received in 2023-03-07, accepted in 2023-08-14,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveTo assess the routine serum and 24-hour urine tests proficiency in diagnosing the baseline metabolic abnormality of kidney stone formers.MethodsThis study analyzes the routine serum and 24-hour urine tests proficiency in diagnosing the baseline metabolic abnormality of kidney stone formers. The sensitivity and specificity, false positive, and negative results of the tests are extracted from diagnostic kits used in the laboratories of the target community. To accurately infer the results, a simulation based on 1000 people was used through 22 standard laboratory tests (Additional File 2), including calcium, oxalate, phosphate, uric acid, sulfate, potassium, sodium, citrate, and magnesium in 24-hour urine; and calcium, creatinine, Vit D, uric acid, and intact parathyroid hormone (PTH) in serum. The incremental cost-effectiveness ratio (ICER) was calculated and compared for each diagnostic test versus other diagnostic tests according to the incremental cost required for correct diagnoses of stone causes.ResultsUrinary uric acid, citrate, and serum potassium constitute the cost-effectiveness boundary curve in this study. This means that other diagnostic tests are not cost-effective compared to these three tests in terms of indexing at least one item of cost and effectiveness. The ICER index for each correct diagnosis with the urinary uric acid test was $ 1.25 per diagnosis, the most cost-effective test compared to serum potassium and urinary citrate.ConclusionThe simplified blood and 24-hour urine metabolic evaluation, including urinary uric acid, citrate, and serum potassium, constitute the cost-effectiveness boundary curve. The most cost-effective test was urinary uric acid measurement.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 2

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