Costs and Effects of Chlamydial Screening: Dynamic versus Static Modeling

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Abstract
The objective of this study was to assess the impact of modeling type on the economic evaluation of screening programs for asymptomatic Chlamydia trachomatis infections. We compared a stochastic network simulation model (dynamic model) with a decision analysis model (static model) for estimating the cost-effectiveness of an opportunistic screening program. The influence of the model type on the required data, the computed results, and the sensitivity of model parameters were investigated. When compared with static modeling, dynamic modeling yielded different cost-effectiveness ratios and identified other optimal screening strategies as it considers changes in the force of infection caused by screening. However, it is more complex, data- and time-demanding, and more sensitive to some parameters affecting the force of infection than static modeling. Dynamic models should be applied for the economic evaluation of prevention measures that have the potential to lower the force of infection such as large-scale chlamydial screening programs.