Analytical approach:
A decision tree was used to synthesise the cost and effectiveness data from published studies and authors' assumptions. The two time horizons were three months and 10 years and the authors stated that the perspective was that of society.
Effectiveness data:
The estimates for screening sensitivity and specificity were derived from a single study (Ullrich, et al. 2005, see ‘Other Publications of Related Interest’ below for bibliographic details). The risk of neurocognitive disability in the long term was estimated based on the results of a study (Lozoff, et al. 2000, see ‘Other Publications of Related Interest’ below for bibliographic details). These clinical end points were used to calculate the rate of anaemia prevention, which was defined as the absolute risk reduction.
Monetary benefit and utility valuations:
Not relevant.
Measure of benefit:
The measure of benefit was the rate of anaemia prevention, as described above.
Cost data:
The costs included those of the screening tests (for reticulocyte haemoglobin, haemoglobin, and the full blood count) and treatment for anaemia and iron deficiency. For the ten-year time horizon, the long-term costs of treatment for neurocognitive disability were also included. The treatment costs were presented as total categories. The costs of the tests were from a laboratory fee schedule and the cost of iron therapy was based on local data. All costs were discounted at an annual rate of 3% and were reported in US dollars ($).
Analysis of uncertainty:
One-way and three-way sensitivity analyses were undertaken to assess the stability of the results over ranges of data for input parameters, such as disease prevalence, treatment duration, rate of follow-up testing, rate of disability, and costs.