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Health Economic Methodology Illustrated with Recent Work on Chlamydia Screening: the Concept of Extended Dominance
  1. Maarten J Postma (m.j.postma{at}
  1. University of Groningen, Netherlands
    1. Robin de Vries ({at}
    1. University of Groningen, Netherlands
      1. Robert Welte (robert.welte{at}
      1. GSF - National Research Center for Environment and Health, Germany
        1. John Edmunds (john.edmunds{at}
        1. Health Protection Agency, United Kingdom


          We reviewed the health economic concepts of dominance on the basis of two recently published cost-effectiveness analyses on screening for asymptomatic Chlamydia trachomatis, one in this journal. On the basis of dominance, some strategies may be deleted from the set options from which to choose. The two investigated studies were from the UK and the Netherlands. Both studies nicely illustrate situations of so-called extended dominance, in practical decision making. Extended dominance is a theoretical topic in many health-economic text books but is only scarcely encountered in "daily practice" health economic studies. Though the concept of extended dominance is theoretical in nature, a formal analysis on this by a health economist may help show which options under consideration are not optimal from a strictly health-economic perspective. Yet, these options might still be attractive policy options for other reasons.

          • Chlamydia trachomatis
          • Health Economics
          • Methodology
          • Screening

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