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The cost-effectiveness of surgical instrument management policies to reduce the risk of vCJD transmission to humans

Stevenson, M.D., Oakley, J.E., Chick, S.E. and Chalkidou, K. (2009) The cost-effectiveness of surgical instrument management policies to reduce the risk of vCJD transmission to humans. Journal of the Operational Research Society, 60 (4). pp. 506-518. ISSN 0160-5682

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Abstract

Current sterilization techniques may not be completely effective at removing prions from surgical instruments, which can then infect patients on whom these instruments are subsequently used. This risk is increased due to the current level of instrument migration. With wide uncertainty in the numbers of patients that are incubating variant Creutzfeldt–Jakob disease (vCJD) and effectiveness of decontamination, the UK is facing a potentially self-sustaining epidemic, which could be averted with the introduction of single-use instruments. This paper focuses on the cost-effectiveness of management strategies concerning the introduction of single-use instruments and measures to prevent migration. We formulated a discrete event simulation model of the dynamics of infection transmission, surgical instrument contamination and migration, to produce results that were pivotal in shaping government policy. Field data about vCJD transmission has then been used to update cost-effectiveness assessments as part of a retrospective analysis, which reinforces the initial decision.

Item Type: Article
Keywords: simulation, cost benefit analysis, hospitals, variant Creutzfeldt–Jakob disease (vCJD), replacement, Bayesian inference
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Science (Sheffield) > School of Mathematics and Statistics (Sheffield)
Depositing User: Mrs Megan Hobbs
Date Deposited: 23 Mar 2010 16:15
Last Modified: 07 Jun 2010 11:10
Published Version: http://dx.doi.org/10.1057/palgrave.jors.2602580
Status: Published
Publisher: Palgrave Macmillan
Identification Number: 10.1057/palgrave.jors.2602580
URI: http://eprints.whiterose.ac.uk/id/eprint/10616

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