Economic evaluations and diagnostic testing: An illustrative case study approach

Sabina Sanghera*, Rosanna Orlando, Tracy Roberts

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

10 Citations (Scopus)


Objective: The aim of this study was to present a clear process of synthesizing test accuracy data when conducting economic evaluations of diagnostic tests for health technology assessment (HTA) assessors and health economists. Methods: We appraised the methods advocated for using diagnostic test accuracy data in economic evaluations. We used a case study of fetal anemia in which data from a screening test are used in combination with a confirmatory test. Results: We developed a step-by-step guide and consider two scenarios: when data on test accuracy from several studies are based on (i) the same test threshold for positivity and (ii) different test thresholds. Conclusions: We conclude that each approach has its strengths and limitations. We show that the optimal operating point of the test should be identified to determine the true cost-effectiveness of the test. We advocate that these issues require a multidisciplinary team of health economists, decision modelers and statisticians.

Original languageEnglish
Pages (from-to)53-60
Number of pages8
JournalInternational Journal of Technology Assessment in Health Care
Issue number1
Publication statusPublished - 2013


  • Diagnostic tests
  • Economic evaluation
  • ROC curve
  • Sensitivity and specificity

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