“Comparing Apples with Oranges.”

Apple_and_Orange_-_they_do_not_compareIn NZ (as with several other parts of the world) there is currently a significant outbreak of pertussis in the population.

In the acute phase of pertussis/whooping cough, some NZ labs offer culture for Bordetella pertussis (with an overall sensitivity of 60-70%) and some offer PCR (with a sensitivity of approx. 90%).

So which is the better test? Purely in terms of efficacy, there is no comparison. (I know which test I would want…)

However the cost of a Bordetella pertussis culture is a few dollars, that of PCR 50-100 dollars. So which one is best now? I guess it depends to some extent on your agenda.

The point I am trying to make here is that the overall value of a test to the health service should not only be considered in terms of performance but also in its cost-effectiveness. There is only a fixed amount of money in the pot with a lot of different hands dipping in.

I am always intrigued by the amount of times I have sat in a conference listening to a speaker discuss a new assay or a new technology. Yet, most of the time, very little is said about the cost, skills required, and the other practicalities of implementing the test in a routine diagnostic lab. To omit such details is essentially only giving half the story and for me indicates somewhat of a detachment from the real world.

I think cost should always be considered when discussing any test. I like to think that microbiology scientists and clinical microbiologists know as much about money as managers do about microbiology.


p.s. For those that are interested I have added a short tutorial to the website on Hepatitis B serological markers, something that always confused me somewhat as a student!

One thought on ““Comparing Apples with Oranges.”

  1. Great post, totally agree with your philosophy here.
    One of the greatest challenges I see now and in the future is deciding how best to utilise the limited health resources to best provide for society (and we all have our own agendas and ideas).

Leave a Reply

Your email address will not be published. Required fields are marked *