Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.— By assessing outcomes in life-years
rather than the limited end point of cost per abnormality, the cited study
by Dr Schechter1 follows the format of a
conventional cost-effectiveness analysis. Nevertheless, it does not address
the use of PAPNET considered by Dr O'Leary and colleagues.2
The comparison with 100% manual rescreening, frequently discussed as a method
that might improve the accuracy of Pap smear testing, is of substantial interest.
The finding that PAPNET identified few additional abnormalities, and at very
high cost, suggests that it is not cost-effective when an excellent laboratory
uses it this way. A more elaborate analysis is not needed to draw this conclusion.
Garber AM. Analysis of Ritonavir for the Treatment of HIV Disease in Children. JAMA. 1998;279(22):1785-1788. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-22-jac80008