Economic impact of the Predict-ITP tool for the diagnosis and treatment of immune thrombocytopenia

Abstract

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by reduced production and augmented destruction of platelets. Adults with ITP have platelet blood counts less than 100x109/L. Ranging from mild to severe, bleeding symptoms may include epistaxis, gingival, petechiae, mucosal, gastrointestinal, vaginal, or intracranial bleeding. ITP can be primary or secondary to other medical conditions. Three phases categorize primary ITP based on the onset and persistence of symptoms: newly diagnosed, persistent, or chronic (1-4). An ITP diagnosis includes a complete blood count, blood film, and viral and autoimmune testing. Depending on patients' comorbidities, the type and number of examinations may vary (3). Diagnosis may also depend on the platelet count response to medications or treatment of secondary causes. There is the need to streamline ITP diagnosis. The time-consuming and high-cost approaches to ruling out other thrombocytopenic conditions, have led Michael G. DeGroote Centre for Transfusion Research (MCTR) researchers to optimize ITP care by developing the Predict-ITP Tool to identify patients with ITP during the initial hematology consultation. The clinical prediction model incorporates data such as platelet count variability, maximum mean platelet volume (MPV), lowest platelet count value, and a history of severe bleeding at any time (5). Improving diagnostic accuracy may improve the quality of life and help reduce expensive, unnecessary, and potentially harmful treatments. Overall, this project vi aims to determine the cost savings of the Predict-ITP tool when implemented in practice, compared to current ITP diagnostic practices. To achieve this goal, in this thesis, we will first estimate the current cost of ITP care and design a health economic evaluation to accompany a randomized controlled trial (RCT) comparing the quality of life and economic impact of the Predict-ITP tool versus current ITP care