{
  "abstract": "Background: Screening for BK polyomavirus (BKPyV) with quantitative polymerase chain reaction (qPCR) or a 2-stage approach with urine cytology followed by qPCR are acceptable strategies. However, the magnitude of the health benefits and incremental cost of adopting these 2 screening strategies are largely unknown.\n\nMethods: Probabilistic Markov models were constructed to evaluate the incremental costs and benefits of (1) screening with qPCR, (2) 2-stage screening, and (3) no routine viral screening. One-way and probabilistic sensitivity analyses were conducted to define the most influential variables in the model.\n\nResults: Screening with either qPCR or 2-stage approaches produce incremental benefit (0.29 and 0.287 quality adjusted life years (QALYs) respectively) and save cost (USD 9,940 and USD11,610), compared with no screening. 2-stage screening associates with cost reduction (USD 1,670) at the expenses of loss in QALY (0.003 QALYs) than screening with qPCR. The incremental cost-effectiveness ratio of the models was sensitive to the graft survival rate and patient survival rate, incidence of BKPyV-DNAaemia, probability of transplantation, sensitivity and cost of urine cytology and qPCR. Screening with 2-stage screening was the best strategy in terms of net monetary benefit across a range of ‘willingness-to-pay’.\n\nConclusions: From the healthcare provider’s perspective, routine BKPyV screening with either qPCR or 2-stage approach (urine cytology followed by qPCR test) is cost-saving and improves QALYs. We demonstrated various factors would affect cost efficiency of 2-stage screening vs screening with qPCR. The transplant centre should consider local factors and the willingness to pay to devise the best screening strategy.\n\nClinical trial number: Not applicable.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12882-026-05244-x.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Special Administrative Region, Hong Kong, China",
    "Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Special Administrative Region, Hong Kong, China",
    "Department of Medicine, Tseung Kwan O Hospital, Special Administrative Region, Hong Kong, China",
    "Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Special Administrative Region, Hong Kong, China",
    "Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Special Administrative Region, Hong Kong, China",
    "Department of Medicine and Geriatrics, Kwong Wah Hospital, Yau Ma Tei, Special Administrative Region, Hong Kong, China",
    "Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, Special Administrative Region, Hong Kong, China",
    "Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Special Administrative Region, Hong Kong, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Maggie Kam-Man Ma",
      "orcid": "0000-0002-7784-8494"
    },
    {
      "affs": [
        1
      ],
      "name": "Jasper Fuk-Woo Chan"
    },
    {
      "affs": [
        2
      ],
      "name": "Tsz-Ling Ho"
    },
    {
      "affs": [
        3
      ],
      "name": "Darwin Chi-Kwan Lam"
    },
    {
      "affs": [
        4
      ],
      "name": "William Lee"
    },
    {
      "affs": [
        5
      ],
      "name": "Ho-Kwan Sin"
    },
    {
      "affs": [
        6
      ],
      "name": "Cheuk-Chun Szeto"
    },
    {
      "affs": [
        7
      ],
      "name": "Chi-Kwan Wong"
    },
    {
      "affs": [
        0
      ],
      "name": "Sydney Chi-Wai Tang",
      "orcid": "0000-0002-6862-1941"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bfez9903cb0bz.bib",
  "cited_by": 0,
  "doi": "10.1186/s12882-026-05244-x",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13746507/",
  "id": "bfez9903cb0bz",
  "issns": [
    "1471-2369"
  ],
  "landing_url": "https://doi.org/10.1186/s12882-026-05244-x",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2730|Polyomavirus and related diseases"
    ]
  ],
  "openalex": "W7202070002",
  "pdf_url": null,
  "pmcid": "PMC13746507",
  "pmid": "43000280",
  "published": "2026-08-10",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/bfez9903cb0bz.ris",
  "sources": [
    {
      "first_seen": "2026-11-11T12:23:52Z",
      "native_id": "PMC13746507",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12882-026-05244-x"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Polyomavirus and related diseases",
      "subfield": "oncology"
    }
  ],
  "title": "Cost utility analysis of two BK polyomavirus screening strategies: quantitative polymerase chain reaction vs 2-stage approach",
  "title_text": "Cost utility analysis of two BK polyomavirus screening strategies: quantitative polymerase chain reaction vs 2-stage approach",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:22:54Z",
  "url": "https://research.draconitic.com/paper/bfez9903cb0bz",
  "venue": "BMC Nephrology",
  "versions": []
}