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Table 2 Six consequences of using BBS instead of VBS for a single new diagnostic test

From: Value-based and benefit-based strategies in deciding to bring a test into use should be distinguished

  

Test has a value

Test has no value

1)

Test-positive patients can benefit from i +

Starts earlier by Δ+Δ b

Starts earlier by Δ+Δ b

2)

Harm to test-positive patients by exposure to i +

Starts earlier by Δ+Δ b

Starts earlier by Δ+Δ b

3)

Test-negative patients can benefit from i +

Not applicable

Delayed by Δ v

4)

Harm to all patients by exposure to test

Starts earlier by Δ+Δ b

In a period of length Δ+Δ b +Δ v

5)

Use of resources for testing all patients

Starts earlier by Δ+Δ b

In a period of length Δ+Δ b +Δ v

6)

Additional off-label use

In a period of length Δ+Δ b +Δ v —harm to patients probable

In a period of length Δ+Δ b —harm to patients less probable