Use of outcomes to evaluate surveillance systems for bioterrorist attacks

Table 1 Decision analytic model inputs

Variable	Value	Range for sensitivity analysis	Source
Health state transition probabilities
Probability of recovery from fulminant anthrax	0	-	[8]
Probability of recovery from prodromal anthrax	0.857	0.66-0.9375	[8]
Probability of prophylactic antibiotic effectiveness	1.0	-	[9]
Probability of developing mild side effects from antibiotics	0.57	0.3-0.57	[10]
Probability of developing severe side effects from antibiotics	0.003	0-0.01	[10]
Probability of seeking medical attention for mild side effects	0.16	0-0.25	[10]
Probability of seeking medical attention for severe side effects	1.0	-	[10]
Health state utility values
Death	0	-
Recovery from anthrax	0.56*	0.4*-0.56^†	[12, 13, 24],
Mild side effects from antibiotics	0.998	0.994-0.999	[10, 14]
Severe side effects from antibiotics	0.992	0.980-0.997	[10]
No side effects from antibiotics - healthy	1.0	-
Cost estimates (2006 USD)
Cost of treatment of prodromal anthrax	9,223	9223-18446^‡	[15–17],
Cost of a course of prophylactic antibiotics	638	-	[19, 20]
Cost of office visit for mild side effects	30	-	[17]
Cost of treatment of severe side effects	189	-	[17, 18]
Willingness to pay to avoid sequelae associated with recovery from anthrax	214,910^§ per year	Life*-5 yrs^†	[12, 22],
Value of a statistical life	7.3 m	5.51 m-13.23 m	[22]

*This health state utility was matched to the EQ-5D [24], and assumed to continue throughout the life span. An average age of 36.5 years was assumed according to the US Census Bureau and average remaining life span of 43 years was calculated using the 2002 US Life Tables [25, 26].
^†A five year duration for this health state utility was used as the upper bound.
^‡The upper bound was estimated by doubling the cost for the base case.
^§This estimate was adjusted to assume that one out of every six anthrax patients would be able to return to work.

ISSN: 1472-6947