222. Cost Justification in IDSA Practice Guidelines
Session: Poster Abstract Session: Clinical Practice Costs, Informatics, and Telemedicine
Thursday, October 8, 2015
Room: Poster Hall
  • Poster.pdf (553.3 kB)
  • Background: Health expenditures are growing faster than the Gross Domestic Product and optimal allocation of available resources remains a significant challenge. We aimed to explore whether guidelines authored by the Infectious Diseases Society of America (IDSA) take into account evidence regarding cost and to identify characteristics of cost analyses that may make their findings more influential in the development of clinical guidelines.

    Methods: We searched the official website of IDSA to identify current guidelines and determined the percentage of guidelines that referenced cost analyses in their recommendations. We also performed PubMed database search with the term used in the retrieved guidelines to identify cost analyses that were relevant to the guidelines. Finally, we designed a 1:1 case-control study to compare included (cases) and not included (controls) cost analyses matched by study subject, in terms of items requested in the CHEERS statement, as well as the impact factor of the publishing journal and the year of publication.

    Results: Forty IDSA guidelines were identified, among which 25 (62.5%) included at least 1 cost analysis in their reasoning. IDSA guidelines were found to incorporate 13.3% (95% CI, 8.5%-18.9%) of the 1,068 available cost analyses retrieved from PubMed. In the case-control study, the mean number of items of the CHEERS statement fulfilled by cases was 14.9 (SD=4.14) comparable to the 14.2 of controls (SD=4.25) (p=0.19). In the itemized comparison, cases were more likely to directly relate their economic outcomes with healthcare outcomes for patients (82% vs. 64% respectively) and that was the only significant difference identified (p=0.04). The mean impact factor of the publishing journal for cases was 8.18, higher than the mean 5.75 for controls, but the difference did not reach statistical significance (p=0.09). The year of publication of cases and controls did not differ (p=0.98).

    Conclusion: The majority of IDSA guidelines use cost analyses to support their recommendations. Over 10% of PubMed identified relevant cost analyses were deemed appropriate for inclusion in guidelines by authoring committees, with an identified advantage of cost analyses that directly related cost data with healthcare outcomes for patients.

    Fainareti Zervou, M.D.1, Ioannis Zacharioudakis, M.D.1, Elina Pliakos, undergraduate student1 and Eleftherios Mylonakis, MD, PhD, FIDSA2, (1)Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, (2)Infectious Diseases, Rhode Island Hospital, Providence, RI


    F. Zervou, None

    I. Zacharioudakis, None

    E. Pliakos, None

    E. Mylonakis, T2 biosystems: Grant Investigator , Research grant
    Astellas Pharma: Board Member and Grant Investigator , Consulting fee and Grant recipient
    Boehringer Ingelheim: Grant Investigator , Research grant

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.