Diagnostic Testing for Sepsis: A Systematic Review of Economic Evaluations

Introduction: Sepsis is a serious and expensive healthcare problem, when caused by a multidrug-resistant (MDR) bacteria mortality and costs increase. A reduction in the time until the start of treatment improves clinical results. The objective is to perform a systematic review of economic evaluations to analyze the cost-effectiveness of diagnostic methods in sepsis and to draw lessons on the methods used to incorporate antimicrobial resistance (AMR) in these studies. Material and Methods: the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the Consolidated Health Economic Evaluation Reporting standards (CHEERS) checklist was used to extract the information from the texts. Results: A total of 16 articles were found. A decision model was performed in 14. We found two ways to handle resistance while modelling: the test could identify infections caused by a resistant pathogen or resistance-related inputs, or outcomes were included (the incidence of AMR in sepsis patients, antibiotic use, and infection caused by resistant bacterial pathogens). Conclusion: Using a diagnostic technique to detect sepsis early on is more cost-effective than standard care. Setting a direct relationship between the implementation of a testing strategy and the reduction of AMR cases, we made several assumptions about the efficacy of antibiotics and the length-of-stay of patients.

Automated summary

This study systematically reviewed economic evaluations to analyze the cost-effectiveness of diagnostic methods in sepsis, as well as explore the incorporation of antimicrobial resistance (AMR) in these studies. The findings suggest that using diagnostic techniques for early detection of sepsis is more cost-effective than standard care. Several assumptions were made regarding the efficacy of antibiotics and patient length-of-stay in order to establish a direct relationship between implementing a testing strategy and reducing AMR cases.