{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T07:49:18Z","timestamp":1776412158039,"version":"3.51.2"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Shanghai Municipal Center for Disease Control and Prevention","award":["GWVI-11.1-05"],"award-info":[{"award-number":["GWVI-11.1-05"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72293585"],"award-info":[{"award-number":["72293585"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72293580"],"award-info":[{"award-number":["72293580"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>China is a high-burden tuberculosis (TB) country and delays in diagnosis and effective treatment have further exacerbated this situation. Whole-genome sequencing (WGS) has emerged as a reliable approach for drug susceptibility testing (DST) in TB. Whole-genome sequencing can not only improve TB treatment outcomes but also requires significant investments in laboratory infrastructure and trained personnel. It is unclear whether WGS is a cost-effective strategy for routine TB diagnosis in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a decision tree\u2013Markov model to evaluate the cost-effectiveness and health impact of WGS-based DST compared with culture-based DST and rapid molecular testing strategies (Xpert and Xpert Ultra), adopting a societal perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Base-case analysis demonstrated that WGS, Xpert, and Xpert Ultra were cost-saving strategies for TB management. Compared with culture-based DST, the incremental net monetary benefits for Xpert, Xpert Ultra, and WGS were $1750.06, $1832.84, and $1939.32, respectively. Over a lifetime horizon, WGS emerged as the optimal DST strategy, reducing direct medical costs by $401.83 per patient, gaining an additional 0.121 quality-adjusted life years per case, and decreasing TB mortality by 45 cases per 10 000 patients. Sensitivity analyses confirmed the robustness of these findings across key parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Whole-genome sequencing\u2013based DST offers a cost-saving solution for patients with TB in China, achieving better health and economic outcomes compared with alternative strategies. The findings suggest that the widespread adoption of WGS-based DST in China would be cost-effective and aligns well with public health priorities in high-burden settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag173","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T12:38:59Z","timestamp":1774096739000},"source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Adopting Whole-Genome Sequencing for Tuberculosis Diagnosis in China: A Cost-Effectiveness Analysis"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6662-690X","authenticated-orcid":false,"given":"Yibei","family":"He","sequence":"first","affiliation":[{"name":"School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuanjing","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6151-6429","authenticated-orcid":false,"given":"Stella","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Public Health, Imperial College London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonan","family":"Fan","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong (Roman)","family":"Xu","sequence":"additional","affiliation":[{"name":"Acacia Lab for Implementation Science, School of Health Management and Dermatology Hospital, Southern Medical University , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 A","family":"Pag\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Public Health Policy and Management, School of Global Public Health, NewYork University , New York, New York ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajun","family":"Yuan","sequence":"additional","affiliation":[{"name":"Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai Children's Medical Center, Affiliated with School of Medicine, Shanghai Jiao Tong University , Shanghai ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[{"name":"School 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