About this Journal Publication ethics Editorial Board Editorial Council Editorial Office For the Authors Contacts
English

News feeds

Journal in Databases

eLIBRARY.RU - ÍÀÓ×ÍÀß ÝËÅÊÒÐÎÍÍÀß ÁÈÁËÈÎÒÅÊÀ

Google Scholar

Google Scholar

Main arrow Archive of previous Issues arrow ¹6 2013 (34) arrow Medical and cost-effectiveness of TB detection by fluorography using double reading of chest films
Medical and cost-effectiveness of TB detection by fluorography using double reading of chest films Print
Friday, 27 December 2013

S.A. Sterlikov1, S.G. Rudnev2, O.V. Obukhova1
1 Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow
2 Research Institute of Phthisiopulmonology, First Moscow State Medical University named after I.M. Sechenov, Moscow

Abstract. Background. Fluorography is the main method of detecting tuberculosis in the Russian Federation. However, efficiency of this method is insufficient. The detection rate of TB patients with fluorography in 2009-2012 was 0.79-0.71 per 1,000 patients (at optimum 1-2 per 1,000). Double reading of chest films is one of the methods to improve efficiency of fluorography.

The aim of the study was to analyze medical and economic efficiency of organizing double reading of chest films.

Methods. Survey of 236 primary health care organizations was conducted in 2009. Double reading of chest films was used in 8.9% of medical institutions serving 13.7% of the population sample. Single reading was used in 25.4% of the institutions for 27.7% of the population sample. The remaining institutions used the dual reading of chest films.

The study shows that universal implementation of the double reading of chest films in Russia can improve detection of tuberculosis through routine chest X-rays by 19% (up to 0.94 per 1,000 tested), as well as increase the share of newly TB cases detected during routine chest X-rays by 19% (up to 65.9%).

It has been calculated that prime cost of X-ray per capita will increase from 46.12 to 49.51 rubles (1.54 to 1.65 USD) (in 2009 prices), while the total primecost of detecting a TB patient with fluorography will decrease by 5663.86 rubles (188.8 USD) (9.8%) and will add up to 52334.39 rubles (1744.48) USD per patient.

Scope of application: primary health care.

Keywords: routine examinations for tuberculosis; fluorography; double reading; economic efficiency of fluorography; prime cost of TB detection per patient.

References

  1. Veybert RA. Usage of various variants of double and triple assessment to improve detectability of tuberculosis and the other pulmonary diseases. Cand.Med.Sci [thesis]. Moscow. 1975. 19 p. (In Russia).
  2. Ivanova ÅS. New cases of pulmonary tuberculosis in adults and optimization of methods for its early detection. Dr.Med.Sci [thesis]. Moscow. 1983. 45 p. (In Russia).
  3. Nezlin SE, Oyfebakh MI. Timely detection of pulmonary tuberculosis in adults. Manual on tuberculosis, 4 volumes. VL. Eynis, editor. Moscow: Medgiz; 1962. Vol. 4. P. 179-213. (In Russia).
  4. On setting labor quotas for the work of medical workers in fluorography rooms: the Letter of the Ministry of Health of the Russian Federation of October 28, 1992 ¹21-01-983 [Internet] 1992 [cited 2013 Aug 05]. Available from: http://www.lawrussia.ru/texts/legal_456/doc456a408x192.htm (In Russia).
  5. Gurevich GL, Skryagina EM, Kalechits OM, Bogomazova AV, Astrovko AP, Zhvalevskaya YaI, et al. Indicator and criteria for assessing the epidemic situation on tuberculosis and efficiency of TB control facilities. Minsk 2008. 17 p. (In Russia).
  6. On measures to strengthen the fight against tuberculosis: the Order of the Ministry of Health of the USSR of September 07, 1972 ¹747 [Internet] 1972 [cited 2013 Aug 05]. Available from: http://www.jurbase.ru/texts/sector173/tez73453.htm (In Russia).
  7. Rudoy NM. Organization of timely detection of patients. Pulmonary tuberculosis. AG. Khomenko, editor. Moscow: Meditsina; 1981. 466 p. (In Russia).
  8. Tuberculosis in the Russian Federation 2011. Analytical review of statistical indicators used in the Russian Federation and the world. Moscow. 2013. 280 p. (In Russia).
  9. Cherednikova AA, Ivanov SI. Health assessment and performance of medical X-ray equipment operating in health facilities of Ryazan region. Rossiyskiy mediko-biologicheskiy vestnik. [Online Serial Journal] [cited 2013 Aug 05]. 2010; (1). Available from: http://www.vestnik.rzgmu.ru/data/files/2012/12/%D0%A7%D0%B5%D1%80%D0%B5%D0%B4%D0%BD%D0%B8%D0%BA%D0%BE%D0%B2.pdf (In Russia).
  10. Shilova MV. Tuberculosis in Russia in 2009. Moscow: Prima Publishing House Ltd; 2010. 192 p. (In Russia).
  11. Birkelo CC, Chamberlain WE, Phelps PS. Tuberculosis case finding: a companion of the effectiveness of various roentgenographic and photofluorographic methods. Journal of the American Medical Association. 1947; 133: 359-366.
  12. Eley AJ, Gough JH. An investigation into the reliability of single reading of miniature chest films. Tubercle. 1960; 41(6): 435 – 440.
  13. Groth-Petersen E, Løvgreen A, Thillemann J. On the reliability of the reading of photofluorograms and the value of dual reading. Acta Tuberculosis Scandinavica. 1952; 26: 13-37.
  14. Groth-Petersen E, Møller V. Observer error in the interpretation of photofluorograms and the value of dual reading in the Danish mass campaign. Acta Tuberculosis Scandinavica. 1955; 30: 209-230.
  15. Holm S, Nielsen H, Møller V, Winge K. On dual reading of photofluorograms. Acta Tuberculosis Scandinavica. 1954; 30: 63-81.
  16. Williams RG. The value of dual reading in mass radiography. Tubercle. 1958; 39 (6): 367 – 371.
  17. Yerushalmy J, Harkness JT, Kennedy BR. The role of dual reading in mass radiography. Am. Rev. of Tuberc. 1950; 61: 443-464

Views: 23713

Be first to comment this article

Write Comment
  • Please keep the topic of messages relevant to the subject of the article.
  • Personal verbal attacks will be deleted.
  • Please don't use comments to plug your web site. Such material will be removed.
  • Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button.
  • Keep in mind that the above process only applies if you simply entered the wrong security code.
Name:
E-mail
Comment:

Code:* Code

Last Updated ( Friday, 27 December 2013 )
< Prev   Next >
home contact search contact search