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Table 3 Effectiveness and cost of tetanus immunity diagnostic strategies in wounded patients in French ED a,b

From: Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments

Cohort Strategies Tetanus case Effectiveness (LY) Vaccine dose TIG dose TQS cost Prophylaxis cost Total cost
All wounded patients Medical Interview 0.41 58,658,086.40 1,033,000 320,000 - € 21,478,000 € 21,564,000
N =1,658,000 TQS 0.02 58,658,087.40 601,000 186,000 € 6,866,000 € 12,490,000 € 19,361,000
  ΔC -0.39 1 -432,000 -134,000 € 6,866,000 -€ 8,988,000 -€ 2,203,000
Patients with a Medical Interview 0.13 40,494,923.00 713,000 - - € 7,118,000 € 7,145,000
Non-tetanus-prone wound TQS 0.01 40,494,923.30 415,000 - € 4,740,000 € 4,139,000 € 8,881,000
N =1,145,000 Δ -0.13 0.3 -298,000 - € 4,740,000 -€ 2,979,000 € 1,736,000
Patients with a Medical Interview 0.28 18,163,163.40 320,000 320,000 - € 14,360,000 € 14,419,000
Tetanus-prone-wound TQS 0.02 18,163,164.10 186,000 186,000 € 2,126,000 € 8,351,000 € 10,480,000
N =513,000 Δ -0.26 0.7 -134,000 -134,000 € 2,126,000 -€ 6,009,000 -€ 3 939,000
Patients 18-64 years Medical Interview 0.04 56,180,160.90 838,000 260,000   € 17,048,000 € 17,438,000
N =1,383,000 TQS 0 56,180,161.00 469,000 145,000 € 5,726,000 € 9,755,000 € 15,482,000
  Δ -0.04 0.10 -369,000 -115,000 € 5,726,000 -€ 7,293,000 -€ 1,956,000
Patients of 65 Medical Interview 0.37 2,477,925.50 195,000 60,000 - € 4,430,000 € 4,126,000
Years and over TQS 0.02 2,477,926.40 132,000 41,000 € 1,140,000 € 2,735,000 € 3,879,000
N =275,000 Δ -0.35 0.9 -63,000 -19,000 € 1,140,000 -€ 1,695,000 -€ 247,000
  1. ED: Emergency departments; LY: Life years; LYG: Life Years Gained; TQS: Tétanos Quick Sticks; TIG: Human tetanus immunoglobulins; N: Cohort size.
  2. aOnly wounded patients over 18 years coming in 2012.
  3. bThe number of tetanus cases with each strategy was low and comparable; differences in effectiveness was negligible. We therefore only focus on costs and consider that the current analysis is a cost-minimization rather than a cost-effectiveness analysis.
  4. cΔ = Defined as the delta of the transition from the “Medical Interview” strategy to the “TQS” strategy.