{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:06:28Z","timestamp":1787893588724,"version":"build-2784847793"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chagas disease remains underdiagnosed in endemic countries due to reliance on centralized laboratory-based algorithms. Rapid diagnostic tests (RDTs) may simplify diagnostic processes and expand access to decentralized testing, but uncertainty remains regarding their performance across heterogeneous settings and long-term economic value. This study evaluated the cost\u2013utility and budget impact of RDT-based diagnostic strategies in Colombia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cost\u2013utility analysis was conducted from the Colombian health system perspective using a hybrid decision tree\u2013Markov model. Three diagnostic strategies were compared: serial RDT with ELISA resolution, hybrid RDT\u2013ELISA and the conventional ELISA algorithm with indirect immunofluorescence assay resolution. Lifetime costs and quality-adjusted life years (QALYs) were estimated. The model incorporated loss to follow-up between steps. Scenario analyses explored correlated test performance and earlier diagnosis among women of reproductive age. A 5-year budget impact analysis was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Lifetime costs were US$319.27, US$266.03 and US$252.74, with corresponding QALYs of 12.30, 12.34 and 12.35 for the conventional, hybrid and serial RDT strategies, respectively. Both RDT-based strategies were economically dominant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RDT-based algorithms may improve access to diagnosis and reduce program costs. Improving completion of the diagnostic process may be a key driver of effectiveness and economic value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/trstmh\/trag050","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:32:31Z","timestamp":1774956751000},"page":"840-850","source":"Crossref","is-referenced-by-count":1,"title":["Rapid diagnostic test-based algorithms for Chagas disease diagnosis: a cost\u2013utility and budget impact analysis in Colombia"],"prefix":"10.1093","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6885-6353","authenticated-orcid":false,"given":"Mario J","family":"Olivera","sequence":"first","affiliation":[{"name":"Grupo de Parasitolog\u00eda, Instituto Nacional de Salud , Bogot\u00e1 111321 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