Key parameters and data sources
Parameter | Base case value (range)* | Data sources |
---|---|---|
Key Lyme disease probability parameters and data sources | ||
Lyme disease | ||
Probability of high-risk exposure | 0.628 (0.471–0.786)† | Personal communication, PHO |
LD incidence rates, per 100 000 (varies by age and sex) | 2.9–13.9 (0.000029–0.000139)‡ | Nelder et al. 20185 |
Probability of clinical diagnosis after EM rash, high-risk exposure area | 0.583 (0.437–0.729)‡ | Henry et al. 201215 |
Probability of clinical diagnosis after EM rash, low-risk exposure area | 0.261 (0.196–0.326)† | Henry et al. 201215 |
Diagnostics | ||
Sensitivity, early localized | 0.463 (0.391–0.537)§ | Waddell et al. 201618 |
Sensitivity, early disseminated | 0.897 (0.783–0.954)§ | Waddell et al. 201618 |
Sensitivity, late disseminated | 0.994 (0.957–0.999)§ | Waddell et al. 201618 |
Specificity, early localized | 0.993 (0.983–0.997)§ | Waddell et al. 201618 |
Specificity, early disseminated | 0.997 (0.984–0.999)§ | Waddell et al. 201618 |
Specificity, late disseminated | 0.993 (0.985–0.997)§ | Waddell et al. 201618 |
Probability of testing (varies by presence or absence of sequelae) | 0.402–0.805 (0.30–0.98)† | Henry et al. 201215 |
Delay in results | 1–2 wk | PHO 201717 |
Treatment | ||
Treatment efficacy | ||
Erythema migrans | 0.85 (0.80–1.00)‡ | Magid et al. 199219 |
Arthritic sequelae | 0.85 (0.40–0.80)‡ | Liu et al. 198920 |
Cardiac sequelae | 0.90 (0.80–1.00)‡ | Steere et al. 199321 |
Neurologic sequelae | 0.90 (0.76–0.97)‡ | Logigian and Steere 199222 Dattwyler et al. 198823 Karlsson et al. 199424 |
Oral treatment completion | 0.90 (0.68–1.00)† | Magid et al. 199219 |
IV treatment completion | 0.99 (0.75–1.00)† | Magid et al. 199219 |
Probability of adverse event, oral | 0.04 (0.03–0.05)† | Shadick et al. 200110 |
Probability of adverse event, IV | 0.06 (0.05–0.08)† | Shadick et al. 200110 |
Outcomes | ||
Probability of hospitalization | 0.05 (0.04–0.06)† | Shing et al. 201925 |
Length of hospitalization, d | 7.9 (3.8–12.1)§ | Shing et al. 201925 |
EM rash | 0.80 (0.60–1.00)† | Shadick et al. 200110 |
Probability of developing sequelae (varies by LD stage and sex) | 0.10–0.17 (0.08–0.21)† | Unpublished data from cited study26** |
Arthritic sequelae (M, F) | 0.56–0.63 (0.41–0.76)† | Unpublished data from cited study26** |
Cardiac sequelae (F, M) | 0.43–0.48 (0.29–0.53)† | Unpublished data from cited study26** |
Cognitive sequelae (F, M) | 0.37–0.44 (0.29–0.58)† | Unpublished data from cited study26** |
Cranial nerve palsy sequelae (F, M) | 0.11–0.24 (0.08–0.26)† | Unpublished data from cited study26** |
Multiple EM sequelae (M, F) | 0.22–0.36 (0.16–0.40)† | Unpublished data from cited study26** |
Meningitis or polyneuropathy sequelae (F, M) | 0.06–0.11 (0.12–0.24)† | Unpublished data from cited study26** |
Key utility parameters and data sources | ||
Utilities | ||
Healthy, stratified by age and sex | 0.62–0.90 (0.38–0.98)§ | Guertin et al. 201813 |
Arthritic sequelae | 0.69 (0.51–0.86)¶ | Shadick et al. 200110 |
Cardiac sequelae | 0.61 (0.38–0.78)¶ | Shadick et al. 200110 |
Cognitive sequelae | 0.60 (0.37–0.73)¶ | Shadick et al. 200110 |
Erythema migrans | 0.80 (0.70–0.93)¶ | Shadick et al. 200110 |
Cranial nerve palsy | 0.61 (0.36–0.81)¶ | Shadick et al. 200110 |
Meningitis or polyneuropathy | 0.52 (0.27–0.73)¶ | Shadick et al. 200110 |
PTLDS | 0.54 (0.30–0.70)¶ | Shadick et al. 200110 |
Minor adverse events, disutility | 0.05 (0.04–0.06)† | Eckman et al. 199712 |
Major adverse events, disutility | 0.10 (0.08–0.13)† | Eckman et al. 199712 |
Oral treatment, disutility | 0.01 (0.00–0.01)† | Eckman et al. 199712 |
Intravenous treatment, disutility | 0.03 (0.02–0.04)† | Eckman et al. 199712 |
Note: CI = confidence interval, EM = erythema migrans, F = female, IQR = interquartile range, IV = intravenous, LD = Lyme disease, M = male, PHO = Public Health Ontario, PTLDS = post-treatment Lyme disease syndrome.
↵* Type of range varies by study, as indicated.
↵† Range represents plausible range.
↵‡ Range represents full range.
↵§ Range represents 95% CI.
↵¶ Range represents IQR.
↵** Study authors provided these data.