{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:04:16Z","timestamp":1789131856003,"version":"build-2803163510"},"reference-count":30,"publisher":"Oceanside Publications Inc.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The cost-effectiveness of school environmental remediation in asthma is not known. The School Inner City Asthma Intervention Study (SICAS2) was a randomized controlled trial that assessed school integrated pest management (IPM) and classroom high efficiency particulate\n air (HEPA) filtration on asthma morbidity in urban schools.  <jats:bold>Objective:<\/jats:bold> The objective was to evaluate the cost-effectiveness of SICAS2.  <jats:bold>Methods:<\/jats:bold> We conducted a cost-effectiveness analysis from a societal perspective that compared four interventions: IPM,\n HEPA, IPM + HEPA, and no intervention. Quality-adjusted life years (QALY) were derived from the EuroQol-5 Dimension-Youth and EuroQol-5 Dimension-3 levels instruments. Total costs (2021 U.S. dollars) included intervention cost, cost of caregiver productivity impacted by child school absenteeism,\n and health-care utilization costs (e.g., emergency department visits). The evaluation period was based on a mean follow-up time of 166 days. Sensitivity analyses were performed by using cost estimates 50% above and below initial cost benchmarks.  <jats:bold>Results:<\/jats:bold> A total of 154\n SICAS2 participants were included. Intervention costs per student were $12.21 (IPM + HEPA), $7.27 (IPM), and $4.94 (HEPA). Sequential analyses revealed that IPM + HEPA was the most cost-effective option, with an incremental cost-effectiveness ratio of $19,667 per\n QALY. Sensitivity analyses demonstrated stability, with variability in probability estimates not exceeding 10%.  <jats:bold>Conclusion:<\/jats:bold> IPM + HEPA demonstrated good value to society, which reflected the low cost and the economic impact of missed school days. This intervention may have\n a pronounced benefit for historically minoritized and marginalized children in urban schools who are disproportionately exposed to air pollution and indoor allergens. The SICAS2 intervention may offer a cost-effective tool to target proximal causes of disparities even in the most resource-limited\n schools.<\/jats:p>","DOI":"10.2500\/aap.2025.46.250018","type":"journal-article","created":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:32:27Z","timestamp":1747441947000},"page":"257-266","source":"Crossref","is-referenced-by-count":6,"title":["Cost-effectiveness of school integrated pest management and air filtration in students with asthma"],"prefix":"10.2500","volume":"46","author":[{"given":"Carmela","family":"Socolovsky","sequence":"first","affiliation":[{"name":"From the Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margee","family":"Louisias","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Harvard University, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleh","family":"Alsulami","sequence":"additional","affiliation":[{"name":"Department of Immunology, Boston Children\u2019s Hospital, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carter R.","family":"Petty","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Design Center, Boston Children\u2019s Hospital, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Division of Pulmonology, Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy S.","family":"Lai","sequence":"additional","affiliation":[{"name":"From the Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparito","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Gaffin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Thorne","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Coull","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Harvard T.H. 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