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Table 4 Parallel Testing Regime: Community Peer Testing Service using Volunteer Peer Nurse Setting (Funded by Federal Government - Medicare and State Government)

From: Economic evaluation of alternative testing regimes and settings to detect undiagnosed HIV in Australia

  True HIV Positive (PHIV) True HIV Negative (1 − PHIV)
Outcomes DHC+, EIA+, WB+ DHC-, EIA+, WB+ DHC+, EIA- DHC-, EIA- DHC+, EIA- DHC+, EIA+, WB- DHC-, EIA+,
WB-
DHC-, EIA-
Probability of result (PHIVSenDHCSenEIASenWB ) (PHIV (1 − SenDHC) SenEIASenWB ) (PHIVSenDHC (1 − SenEIA)) (PHIV
(1 − SenDHC)  (1 − SenEIA))
((1 − PHIV)  (1 − SpecDHC) SpecEIA ) ((1 − PHIV)  (1 − SpecDHC)  (1 − SpecEIA) SpecWB ) ((1 − PHIV) SpecDHC (1 − SpecEIA) SpecWB ) ((1 − PHIV) SpecDHCSpecEIA )
Inputs
Visit 1: Initial Screening – Volunteer Peer Testing Facilitators
  Consult time 20 min 20 min 20 min 20 min 20 min 20 min 20 min 20 min
  Staff Wage (Rate/Hour): $0 $0 $0 $0 $0 $0 $0 $0
  Staffing Volunteer Nurse Volunteer Nurse Volunteer Nurse Volunteer Nurse Volunteer Nurse Volunteer Nurse Volunteer Nurse Volunteer Nurse
Pathology costs
  Rapid Alere Determine Test $11 $11 $11 $11 $11 $11 $11 $11
  EIA test $15.651 $15.651 $15.651 $15.651 $15.651 $15.651 $15.651 $15.651
  WB confirmatory $29.002 $29.002     $29.002 $29.002  
Visit 2: Test Results – Community Peer Organisation Bulk Billing GP Clinic
  Consult time 40 min 40 min 20 min   20 min 20 min 20 min  
  Medicate Rebate $105.553 $105.553 $71.704   $71.704 $71.704 $71.704  
  Staffing GP GP GP   GP GP GP  
Total Cost of Each Outcome $161.20 $161.20 $98.35 $26.65 $98.35 $127.35 $127.35 $26.65
Average cost per person tested =(PHIVSenDHCSenEIASenWB) AC per True HIV PositiveDHC + , EIA + , WB+ + (PHIV (1 − SenDHC) SenEIASenWB) AC per True HIV PositiveDHC − , EIA + , WB+ + (PHIVSenDHC (1 − SenEIA)) AC per False NegativeDHC + , EIA + (PHIV (1 − SenDHC)  (1 − SenEIA)) AC per False NegativeDHC − , EIA + ((1 − PHIV)  (1 − SpecDHC) SpecEIA) AC per False HIV PositiveDHC + , EIA + ((1 − PHIV)  (1 − SpecDHC)  (1 − SpecEIA) SpecWB) AC per False HIV PositiveDHC + , EIA + , WB + ((1 − PHIV) SpecDHC (1 − SpecEIA) SpecWB) AC per False HIV PositiveDHC − , EIA + , WB + ((1 − PHIV) SpecDHCSpecEIA) AC per True NegativeDHC − , EIA
Average number of tests for a positive diagnosis \( =\frac{1}{\left({P}_{HIV}\ast Se{n}_{DHC}\ast Se{n}_{EIA}\ast Se{n}_{WB}\right)+\left({P}_{HIV}\ast \left(1- Se{n}_{DHC}\right)\ast Se{n}_{EIA}\ast Se{n}_{WB}\right)} \)
  1. Note: AC Average Cost, DHC Alere Determine™ HIV-1/2 Ag/Ab Combo Test, EIA fourth generation enzyme immunoassay test, GP General Practitioner, P Probability, Sen Sensitivity, Spec Specificity, WB Western Blot Test, + reactive test result, − nonreactive test result. 1 = Medicare Rebate Item 69,384; 2 = Medicare Rebate Item 69,387; 3 = Medicare Rebate Item 44; 4 = Medicare Rebate Item 36