{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T01:00:50Z","timestamp":1780275650394,"version":"3.54.0"},"reference-count":55,"publisher":"CSIRO Publishing","issue":"3","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate the cost-effectiveness of an emergency department (ED) syphilis screening program for the Aboriginal and Torres Strait Islander population (aged 15\u201340\u00a0years) presenting to a regional Australian ED, compared with no screening program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A decision tree model was developed using clinical data from a previous audit and outcome probabilities from the literature. We included direct financial costs from a healthcare provider perspective and outcomes measured in quality-adjusted life years (QALYs) gained, over a 40-year time horizon. Costs were derived from the Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, and hospital costs classified according to the Australian refined diagnosis-related groups. Both costs and outcomes were discounted by 5% per year. An incremental cost-effectiveness ratio was estimated and subjected to sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>With a background syphilis prevalence of 0.68%, screening Aboriginal and Torres Strait Islander peoples, aged 15\u201340\u00a0years, presenting to a regional ED compared with no screening was A$134,802 per QALY gained. The program becomes cost-effective (using a willingness-to-pay threshold of A$50,000) at a syphilis prevalence of 1.55%. The incremental cost-effectiveness ratio was most sensitive to probabilities of syphilis progression, syphilis prevalence and specificity of the initial screening test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The ED syphilis screening program for Aboriginal and Torres Strait Islander peoples was not cost-effective with the current background rate of syphilis. However, similar screening programs in settings with a higher burden of syphilis may be cost-effective, and further refining the target population based on additional risk factors could help reduce costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh25224","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:12:17Z","timestamp":1780272737000},"source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness of an opt-out emergency department screening program for syphilis in North Queensland\u2019s Aboriginal and Torres Strait Islander population"],"prefix":"10.1071","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7671-6808","authenticated-orcid":true,"given":"Leah","family":"Moncrieff","sequence":"first","affiliation":[{"name":"ACollege of Medicine and Dentistry, James Cook University, Mackay, Qld 4740, Australia."},{"name":"BJCU Mackay Clinical School, Ngudya Yamba Campuses, Building K Level 1, Mackay Base Hospital, 475 Bridge Road, Mackay, Qld 4740, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Heal","sequence":"additional","affiliation":[{"name":"ACollege of Medicine and Dentistry, James Cook University, Mackay, Qld 4740, Australia."},{"name":"BJCU Mackay Clinical School, Ngudya Yamba Campuses, Building K Level 1, Mackay Base Hospital, 475 Bridge Road, Mackay, Qld 4740, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Hall","sequence":"additional","affiliation":[{"name":"ACollege of Medicine and Dentistry, James Cook University, Mackay, Qld 4740, Australia."},{"name":"BJCU Mackay Clinical School, Ngudya Yamba Campuses, Building K Level 1, Mackay Base Hospital, 475 Bridge Road, Mackay, Qld 4740, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Lawton","sequence":"additional","affiliation":[{"name":"CTownsville University Hospital, Townsville, Qld 4814, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-7403","authenticated-orcid":true,"given":"Jason J.","family":"Ong","sequence":"additional","affiliation":[{"name":"DMonash University, Melbourne, Vic, Australia."},{"name":"EMelbourne Sexual Health Centre, Melbourne, Vic, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"2026053120121094900_R1","unstructured":"Australian Centre for Disease Control. 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