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Table 2 Selected clinical variables for compared treatment protocols.

From: Treating cutaneous leishmaniasis patients in Kabul, Afghanistan: cost-effectiveness of an operational program in a complex emergency setting

 

Probability Distribution

 

Simulation Output

Reference

Treatment Efficacy

    

'Standard Treatment'

Triangular

0.70 Kabul estimate

0.701

Estimated from 17

  

0.93 [Maximum]

 

Estimated from 18 and 20

  

0.48 [Minimum]

 

Estimated from 19 and 21

Intralesional SbV (a)

Triangular

0.75 Kabul estimate

0.721

17†

  

0.91 [Maximum]

 

18†

  

0.50 [Minimum]

 

19‡

Intramuscular SbV (b)

Triangular

0.45 Kabul estimate

0.604

17

  

1.00 [Maximum]

 

20†

  

0.36 [Minimum]

 

21‡

Treatment Compliance

    

'Standard Treatment'

Triangular

0.74 Kabul estimate

0.824

Estimated from 17

  

1.00 [Maximum]

 

Estimate, not based on data

  

0.74 [Minimum]

 

Estimated from 17

Intralesional SbV (d)

Triangular

0.76 Kabul estimate

0.840

17

  

1.00 [Maximum]

 

Estimate, not based on data

  

0.76 [Minimum]

 

17

Intramuscular SbV (e)

Triangular

0.62 Kabul estimate

0.750

17

  

1.00 [Maximum]

 

Estimate, not based on data

  

0.62 [Minimum]

 

17

Duration of disease (years)

  

1.000

Estimate, not based on data

  1. Parameter distribution was simulated as described using @risk software. The triangular distribution was used to describe clinical parameter distributions. This is standard practice in cost-effectiveness analyses22 to estimate parameter inputs for which the variation is known (minimum and maximum estimates, Kabul estimate), but for which the precise nature of the distribution is not. Parameter estimates were taken from published clinical trials evaluating treatment alternatives for cutaneous leishmaniasis (minimum and maximum estimates) with data from HealthNet TPO's operational program in Kabul (Kabul estimate)17 being our 'best guess' and, hence, mode of the distribution. a, b, d, e refer to parameter estimates used in Figure 1. Drug efficacy estimates came from studies evaluating the therapeutic efficacy of pentavalent antimonial drugs (SbV) for cutaneous leishmaniasis, i.e. sodium stibogluconate (†) or meglumine antimoniate (‡)
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BMC Infectious Diseases

ISSN: 1471-2334

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