Skip to main content

Table 2 Model parameters base case values and ranges used in the sensitivity analyses

From: Effectiveness and cost of quick diagnostic tests to determine tetanus immunity in patients with a wound in french emergency departments

Parameter Base case value Min Max Source
Annual number of patients ≥18 years coming to French EDs 12,757,000 12,223,000 13,243,000 [12]
Cohort size (wounded patients ≥18 years coming to the French EDs) 1,658,000 1,589,000 1,722,000 Calculus based on [13] and [12]
Pr wound│ED consultation 13.0% 10.0% 15.0% [13]
Pr tetanus-prone wound│wound 31.0% 18.1% 77.3% [5],[6],[14]-[17]
Pr highly tetanus-prone wound│wound 4.9%    [6]
Pr patients ≥65 years in the cohort 16.6% 10.0% 20.0% [8],[12]
Pr men in the cohort 70.3% 45.7% 75.0% [5],[6],[8],[15],[16]
Life expectancy (Pr men in the cohort ×Average men's life expectancy of the age group) + ((1- Pr men in the cohort)×Average women's life expectancy of the age group)    
 18 to 64 years 40.9 38.9 44.7 [18]
 ≥65 years 9.1 8.4 10.4  
Pr vaccination card 11.9% 0.0% 19.6% [5],[14],[16]
Medical interview sensitivity 62.0% 38.0% 65.0% [4]-[8]
Medical interview specificity 79.0% 66.0% 96.0% [4]-[8]
TQS sensitivity 69.0% 55.0% 96.0% [4]-[8],[19],[20]
TQS specificity 98.0% 87.2% 100.0% [4]-[8],[19],[20]
Seroprevalence (≥0.1 IU/mL)     
 18 to 64 years 94.6% 84.0% 96.6% [5]
 ≥65 years 76.6% 72.2% 83.3% [21]
Pr of being up-to-date with booster shots     
 18 and 64 years (last booster less than 20 years ago) 71.2% 70.0% 81.0% [22]
 ≥65 years (last booster less than 10 years ago) 44.0% 44.0% 77.0% [11]
Pr of booster being assessed as up-to-date (Medical interview sensitivity×Pr up-to-date with boosters) + ((1-Medical interview specificity)    
  ×(1-Pr up-to-date with boosters))    
 18 to 64 years 50.2%    
 ≥65 years 39.0%    
Pr positive TQS (TQS sensitivity×Seroprevalence) + ((1-TQS specificity)×(1-Seroprevalence))    
 18 and 64 years 65.7%    
 ≥65 years 53.3%    
Pr of patient reporting having a complete primary vaccination 69.9% 71.5% 50.4% [5],[15]
Medical interview PPV Pr up-to-date with boosters×Medical interview sensitivity/((Pr up-to-date with boosters×Medical interview sensitivity) + ((1-Pr up-to-date with boosters)×(1-Medical interview specificity)))    
 18 to 64 years 88.0%    
 ≥65 years 69.9%    
Medical interview NPV (1-Pr up-to-date with boosters)×Medical interview specificity/(((1-Pr up-to-date with boosters)    
  ×Medical interview specificity) + (Pr up-to-date with boosters×(1-Medical interview sensitivity)))    
 18 to 64 years 45.7%    
 ≥65 years 72.6%    
TQS PPV Seroprevalence×TQS sensitivity/((Seroprevalence×TQS sensitivity) + ((1-Seroprevalence)×(1-TQS specificity)))    
 18 to 64 years 99.8%    
 ≥65 years 99.1%    
TQS NPV (1-Seroprevalence)×TQS specificity/(((1-Seroprevalence)×TQS specificity ) + (Seroprevalence×(1-TQS sensitivity)))    
 18 to 64 years 15.3%    
 ≥65 years 49.1%    
TIG relative risk on tetanus occurrence 0    Institut de veille sanitaire expert assumption
Tetanus vaccine relative risk on tetanus occurrence 1    Institut de veille sanitaire expert assumption
Pr hospitalization│tetanus case 100%    [23]-[26]
Pr death│tetanus case     
 <70 years 10.0% 0% 100.0% [23]-[26]
 ≥70 years 27.2% 0% 42.0% [23]-[26]
Pr sequelae│surviving tetanus case 31.6% 18.8% 50.0% [23]-[26]
c TQS (€ 2012) € 4.7 € 4 € 5 [9],[17]
c tetanus vaccine (Revaxis®: 0.5 mL syringe) (€ 2012) € 10.0 € 3 € 15 [27]
c human TIG (Gammatetanos®: 250 IU/2 mL syringe) (€ 2012) € 34,9 € 30 € 40 [27]
c hospitalization tetanus case (€ 2012) € 209,000 € 150,000 € 250,000 [28]
c sequelae of a tetanus case (€ 2012) € 5,663 € 5,000 € 6,000 [28]
  1. Pr: probability; c: cost; │: among (in case of a conditional probabilities); ED: Emergency Department; TQS: Tétanos Quick Stick; TIG: Tetanus immunoglobulins; PPV: Positive predictive value; NPV: Negative predictive value; GP: General practitioner.