#3-96E. Rethinking Inflammation: The Cost-Effectiveness of Combined ESR and CRP Testing (CEOR 2026)

Do you routinely order both CRP and ESR when evaluating inflammation in your daily practice? Today, we explore the study "Economic Evaluation of Combined Testing Strategies Using Erythrocyte Sedimentation Rate and C-Reactive Protein Tests," which assesses the cost-effectiveness of combined testing versus CRP alone in U.S. hospitals. Using a decision tree economic model, researchers demonstrated that requiring both tests to be positive significantly reduces overall misdiagnoses—particularly false positives—leading to substantial net healthcare cost savings. The most crucial clinical takeaway is that a targeted "both-positive" strategy is not merely a diagnostic redundancy, but a highly effective approach that minimizes unnecessary follow-up care compared to CRP alone or an "either-positive" strategy. However, when critically appraising this paper, clinicians should be cautious that for certain conditions, the authors assumed the two test results were statistically independent to estimate combined diagnostic accuracy, which might oversimplify complex clinical realities. Ultimately, this research empowers physicians to optimize their routine diagnostic workflows, demonstrating how a mindful, combined interpretation of these conventional markers can simultaneously enhance diagnostic precision and promote value-based care.

Citation: Yarnoff B, et al. Economic Evaluation of Combined Testing Strategies Using Erythrocyte Sedimentation Rate and C-Reactive Protein Tests. ClinicoEconomics and Outcomes Research. 2026. DOI: 10.2147/CEOR.S578961

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.