{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:24:15Z","timestamp":1787016255423,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T00:00:00Z","timestamp":1585526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A pre\u2010plasma exchange ADAMTS13 measurement differentiates thrombotic thrombocytopenic purpura (TTP) from other forms of thrombotic microangiopathy (TMA). Given that many hospitals do not perform the ADAMTS13 assay in\u2010house and that the turnaround time (TAT) differs among reference laboratories, we performed an analysis investigating the potential impact of a delay in obtaining the results on the healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An economic model was developed to estimate the impact of a delay in obtaining the pretreatment ADAMTS13 results on patients admitted with TMA with cost (US dollars) as the primary outcome. Incremental cost\u2010effectiveness ratio (ICER) as a composite outcome was calculated from both cost and life days [LDs], an effectiveness surrogate marker. Model parameters were gathered from the medical literature, except for the institutional cost of the ADAMTS13 test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In patients with TMA, during the 6\u2010day study period, the incremental cost to the healthcare system ranged from approximately $4155 to $5123 for every 1\u2010day delay in obtaining the pre\u2010exchange ADAMTS13 results with virtually no change in the effectiveness marker. The ICER composite outcome established the cost\u2010effectiveness of having a fast TAT for pre\u2010exchange ADAMTS13 results. Probabilistic sensitivity analyses also confirmed the robustness of the model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with clinical presentations of TMAs, having a rapid TAT for pre\u2010exchange ADAMTS13 measurement appeared to be cost\u2010effective. If testing cannot be performed in\u2010house, then our findings support the necessity of contracting with a reference laboratory that can reliably provide the result, preferably within 1\u00a0day of admission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/vox.12912","type":"journal-article","created":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T07:16:43Z","timestamp":1585552603000},"page":"433-442","source":"Crossref","is-referenced-by-count":14,"title":["Potential impact of a delayed ADAMTS13 result in the treatment of thrombotic microangiopathy: an economic analysis"],"prefix":"10.1111","volume":"115","author":[{"given":"Chong H.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy University of Colorado Anschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sierra C.","family":"Simmons","sequence":"additional","affiliation":[{"name":"Department of Pathology Michigan Pathology Specialists Spectrum Health Hospitals Grand Rapids MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah F.","family":"Wattar","sequence":"additional","affiliation":[{"name":"Department of Pathology Keck School of Medicine of the University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameneh","family":"Azad","sequence":"additional","affiliation":[{"name":"Department of Pathology Keck School of Medicine of the University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4168-3859","authenticated-orcid":false,"given":"Huy P.","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Pathology Keck School of Medicine of the University of Southern California Los Angeles CA 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