The value of In vitro diagnostic testing in medical practice : a status report

Show simple item record Rohr, Ulrich-Peter Binder, Carmen Dieterle, Thomas Giusti, Francesco Messina, Carlo Guiseppe Mario Toerien, F.E. (Franz Eduard) Moch, Holger Schafer, Hans Hendrik 2016-05-18T07:26:07Z 2016-05-18T07:26:07Z 2016-03-04
dc.description S1 Fig. Average (cardiologists, oncologists, USA, Germany) percentage of IVD subtype use and average rated importance of IVD subtype use during initial patient workup. (DOCX) en_ZA
dc.description S1 File. Stage 2 –Oncology questionnaire. (DOCX) en_ZA
dc.description S2 File. Stage 2 –Cardiology questionnaire. (DOCX) en_ZA
dc.description S3 File. Stage 2 –Interview answers from oncologists and cardiologists. (XLSX) en_ZA
dc.description S4 File. Stage 3 –SERMO questions. (DOCX) en_ZA
dc.description S5 File. Stage 3 –Physician answers to SERMO questions. (XLSX) en_ZA
dc.description S1 Table. IVD Total Spending and Percentage of HCE 1993–2013 for US and Germany. (DOCX) en_ZA
dc.description S2 Table. IVD subtype usage and rated importance. A) Percentage of IVD subtype use during initial patient workup according to specialty and country; B) Rated importance of IVD subtypes for clinical practice and decision making during initial patient workup according to specialty and country (rating based on Likert scale, 1 = very low, 5 very high). (DOCX) en_ZA
dc.description.abstract BACKGROUND In vitro diagnostic (IVD) investigations are indispensable for routine patient management. Appropriate testing allows early-stage interventions, reducing late-stage healthcare expenditure (HCE). AIM To investigate HCE on IVDs in two developed markets and to assess the perceived value of IVDs on clinical decision-making. Physician-perceived HCE on IVD was evaluated, as well as desired features of new diagnostic markers. METHODS Past and current HCE on IVD was calculated for the US and Germany. A total of 79 US/German oncologists and cardiologists were interviewed to assess the number of cases where: physicians ask for IVDs; IVDs are used for initial diagnosis, treatment monitoring, or posttreatment; and decision-making is based on an IVD test result. A sample of 201 US and German oncologists and cardiologists was questioned regarding the proportion of HCE they believed to be attributable to IVD testing. After disclosing the actual IVD HCE, the physician’s perception of the appropriateness of the amount was captured. Finally, the association between physician-rated impact of IVD on decision-making and perceived contribution of IVD expenditure on overall HCE was assessed. RESULTS IVD costs account for 2.3% and 1.4% of total HCE in the US and Germany. Most physicians (81%) believed that the actual HCE on IVDs was >5%; 19% rated the spending correctly (0–4%, p<0.001). When informed of the actual amount, 64% of physicians rated this as appropriate (p<0.0001); 66% of decision-making was based on IVD. Significantly, more physicians asked for either additional clinical or combined clinical/health economic data than for the product (test/platform) alone (p<0.0001). CONCLUSIONS Our results indicate a poor awareness of actual HCE on IVD, but a high attributable value of diagnostic procedures for patient management. New markers should deliver actionable and medically relevant information, to guide decision-making and foster improved patient outcomes. en_ZA
dc.description.department Accounting en_ZA
dc.description.librarian am2016 en_ZA
dc.description.sponsorship Roche Divisional Diagnostics, Medical and Scientific Affairs en_ZA
dc.description.uri en_ZA
dc.identifier.citation Rohr U-P, Binder C, Dieterle T, Giusti F, Messina CGM, Toerien E, et al. (2016) The Value of In Vitro Diagnostic Testing in Medical Practice: A Status Report. PLoS ONE 11(3): e0149856. DOI: 10.1371/journal.pone.0149856. en_ZA
dc.identifier.issn 1932-6203
dc.identifier.other 10.1371/journal.pone.0149856
dc.language.iso en en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights © 2016 Rohr et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.subject Patient management en_ZA
dc.subject In vitro diagnostic (IVD) en_ZA
dc.subject Healthcare expenditure (HCE) en_ZA
dc.title The value of In vitro diagnostic testing in medical practice : a status report en_ZA
dc.type Article en_ZA

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