From: Priorities among effective clinical preventive services in British Columbia, Canada
Clinical Preventive Services | CEa (1.5% Discount Rate) | Key Variable(s) | Base Value | Range | |||
---|---|---|---|---|---|---|---|
Base | Range | ||||||
Screening for Asymptomatic Disease or Risk Factors - Youth | |||||||
 Screening for depression | $28,215 | $21,555 | $45,994 | Reduction in quality of life due to depression | 31% | 15% | 45% |
Behavioural Counseling Interventions - Children/Youth | |||||||
 Interventions to support breastfeeding | ($9021) | ($14,757) | $19,699 | % of women attending interventions who exclusively breastfeed at 6 months | 44% | 13% | 84% |
 Growth monitoring and healthy weight management in children and youth | $29,436 | $10,148 | $524,527 | Length of time that avoided costs accrue | Lifetime | 10 Years |  |
 Preventing tobacco use (school-aged children & youth) | ($7349) | ($10,083) | $23,905 | % of smokers who cease as a result of intervention(s) | 34% | 5% | 69% |
Preventive Medication / Devices - Children | |||||||
 Fluoride varnish | $43,038 | $16,391 | $86,076 | Change in quality of life due to improved oral health | 0.01 | 0.005 |  |
Frequency of fluoride varnish application | Every 6 months |  | Annually | ||||
 Dental sealants | ($24,690) | ($32,248) | ($17,132) | Cost of dental fillings | $92.75 | $83.10 | $102.40 |
Screening for Asymptomatic Disease or Risk Factors - Adults | |||||||
 Screening for breast cancer | $19,720 | $11,659 | $45,514 | % reduction in breast cancer deaths as a result of mammogram screening | 21% | 10% | 32% |
 Screening (cytology-based) for cervical cancer | $25,542 | $13,818 | $99,328 | Effectiveness of screening in reducing cervical cancer deaths / incidence | 35% / 44% | 10% / 25% | 53% / 58% |
 Addition of HPV-based cervical cancer screening | ($21,556) | ($16,414) | ($23,377) | % improvement in HPV-screening effectiveness vs. cytology-based screening | 55% | 19% | 75% |
 Screening for colorectal cancer | $47,265 | $32,923 | $82,979 | Effectiveness of screening in preventing colorectal cancer deaths | gFOBT - 18% | 8% | 27% |
Colonoscopy - 26% | 18% | 33% | |||||
 Screening for lung cancer | $2240 | $1228 | $9206 | % of lung cancer deaths avoided with screening | 19.6% | 7.7% | 30.0% |
 Screening for hypertension | $15,254 | $9314 | $24,485 | Effectiveness of drug treatment in reducing cardiovascular and cerebrovascular events | Cardio - 22% | 17% | 29% |
Cerebro - 41% | 33% | 48% | |||||
 Screening for cardiovascular disease risk and treatment (with statins) | $3223 | $1458 | $7849 | Effectiveness of drug treatment in reducing all-cause mortality, myocardial infarction and stroke | Mortality - 14% | 7% | 20% |
MI - 36% | 29% | 43% | |||||
Stroke - 29% | 18% | 38% | |||||
 Screening for type 2 diabetes mellitus (T2DM) | ($3121) | ($6348) | $1121 | Proportion of office visit for screening | 50% | 33% |  |
 Screening for depression in general adult population | Dominated |  |  |  |  | ||
 Screening for depression in pregnant and postpartum women | $23,042 | $11,149 | $43,255 | % reduction in depression risk due to screening | 32% | 18% | 59% |
 Screening for osteoporosis | ($29,412) | ($43,257) | $38,997 | Change in the effectiveness of screening / treatment |  |  |  |
Hip fracture reduction rate | 23% | 8% | $36 | ||||
Vertebral fracture reduction rate | 26% | 12% | $38 | ||||
 Screening for abdominal aortic aneurysm (AAA) | $11,995 | $9328 | $38,251 | Change in the relative risk of AAA-related mortality | 0.58 | 0.39 | 0.88 |
Screening for Sexually Transmitted Infections and Blood Borne Pathogens - Adults | |||||||
 Screening for human immunodeficiency virus | $16,434 | ($12,463) | $80,739 | % reduction in HIV transmission rate with early antiretroviral therapy | 64% | 25% | 96% |
 Screening for chlamydia and gonorrhea | $57,174 | $37,189 | $234,414 | Effectiveness of screening in reducing pelvic pain, infertility and ectopic pregnancy | 41% | 10% |  |
 Screening for hepatitis C virus | $3427 | $2570 | $5141 | Probability of cirrhosis in Hepatitis C Virus positive individuals | 15% | 10% | 20% |
Behavioural Counseling Interventions - Adults | |||||||
 Prevention of sexually transmitted infections (STIs) | $10,267 | $6921 | $22,513 | Effectiveness of high intensity behavioural counselling interventions in reducing the incidence of STIs in adolescents and adults | Adolescents - 62% | 40% | 74% |
Adults - 30% | 13% | 44% | |||||
 Counselling and interventions to prevent tobacco use | ($1863) | ($3441) | $779 | Quit rate for smoking as a result of intervention | 28.0% | 23.0% | 33.6% |
 Screening and behavioural counseling interventions to reduce unhealthy alcohol use | $9609 | ($375) | $23,676 | Frequency of screening | Annual |  | Every 5 yrs |
Effectiveness of counselling in changing behaviour | 13.9% | 8.7% | Â | ||||
 Screening for and management of obesity | $12,160 | $5682 | $28,565 | Frequency of measuring of height / weight, physical activity and diet advice | Every 2 yrs | Annual | Every 3 yrs |
 Preventing falls | $35,213 | $13,950 | $77,738 | Cost of exercise per hour | $5.00 | $0.00 | $15.00 |
Preventive Medication / Devices - Adults | |||||||
 Routine aspirin use for the prevention of cardiovascular disease (CVD) and colorectal cancer | $2302 | -$1189 | $24,255 | Effectivenes of aspirin in reducing risk of cardiovascular disease, cerebrovascular disease, and colorectal cancer incidence and death | Cardio - 17% | 6% | 26% |
Cerebro - 14% | 2% | 24% | |||||
CRC Incidence - 40% | 24% | 53% | |||||
CRC Mortality - 33% | 14% | 48% | |||||
 Folic acid supplementation for the prevention of neural tube defects | $195,379 | $88,410 | $431,770 | Frequency of advice on folic acid supplementation | Annual |  | Every 3 yrs |