Cost-consequence analysis of computer vision-based skin prick tests: implications for cost containment in Switzerland

• Published in: BMC health services research Vol. 24; no. 1; pp. 988 - 11
• Main Author: Uwitonze, Jean Pierre
• Format: Journal Article
• Language: English
• Published: London BioMed Central 26.08.2024; BioMed Central Ltd; BMC
• Subjects: Adults; Allergens; Allergies; Allergy; Analysis; Asthma; Automation; Computer vision; Cost Control - methods; Cost savings; Cost-consequence; Costs; Decision trees; Diagnosis, Computer-Assisted - economics; Diagnosis, Computer-Assisted - methods; Female; Grey literature; Hay fever; Health Administration; Health aspects; Health Informatics; Hospitals; Hospitals, University; Humans; Hypersensitivity - diagnosis; Hypersensitivity - economics; Machine vision; Male; Medical care, Cost of; Medicine; Medicine & Public Health; Monte Carlo Method; Nursing Research; Patients; Public Health; Sensitization; Skin prick test; Skin Tests - economics; Skin Tests - methods; Software; Switzerland; Testing; Switzerland; Allergy; Cost savings; Cost containment; Healthcare evaluation; Skin prick test; Sensitization; Decision tree; Cost-consequence; Hay fever
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-024-11433-x

Background Skin prick tests (SPTs), or intraepidermal tests, are often the first diagnostic approach for people with a suspected allergy. Together with the clinical history, SPTs allow doctors to draw conclusions on allergies based on the sensitization pattern. The purpose of this study is to investigate the potential cost consequences that would accrue to a Swiss University hospital after the adoption of computer vision-based SPTs. Methods We conducted a cost-consequence analysis from a hospital’s perspective to evaluate the potential cost consequences of using a computer vision-based system to read SPT results. The patient population consisted of individuals who were referred to the allergology department of one of the five university hospitals in Switzerland, Inselspital , whose allergology department averages 100 SPTs a week. We developed an early cost-consequence model comparing two SPT techniques; computer vision - based SPTs conducted with the aid of Nexkin DSPT and standard fully manual SPTs. Probabilistic sensitivity analysis and additional univariate sensitivity analyses were used to account for uncertainty. Results The difference in average cost between the two alternatives from a hospital’s perspective was estimated to be CHF 7 per SPT, in favour of the computer vison-based SPTs. Monte Carlo probabilistic simulation also indicated that SPTs conducted using the computer vision-based system were cost saving compared to standard fully manual SPTs. Sensitivity analyses additionally demonstrated the robustness of the base case result subject to plausible changes in all the input parameters, with parameters representing the costs associated with both SPT techniques having the largest influence on the incremental cost. However, higher sensitization prevalence rates seemed to favour the more accurate standard fully manual SPTs. Conclusion Against the backdrop of rising healthcare costs especially in Switzerland, using computer-aided or (semi) automated diagnostic systems could play an important role in healthcare cost containment efforts. However, results should be taken with caution because of the uncertainty associated with the early nature of our analysis and the specific Swiss context adopted in this study.