{"text_format":"1","workbook":"xlsx","n_sheets":19,"sheets":["Cover","Overview","Instructions","Inputs-Current test volumes","Inputs-Reductions in testing","Inputs-Direct costs","Inputs-Analyzer Time","Inputs-Abnormal tests","Results","Appendices and References","Bkg-Ref scenario","Bkg-ND scenario","Bkg-Impact Results","Dropdowns","Central NS test numbers","EORLA Cost data","Test time","Data Store","Query Indirect costs"],"not_rendered":{"charts":0,"images":2,"macros":1,"external_links":0,"defined_names":22,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Cover","index":0,"n_rows":41,"n_cols":7,"rows_kept":41,"cut":false,"hidden":false,"merged":[[40,3,41,23],[7,3,10,23],[18,3,19,23],[21,3,22,23],[24,3,26,23],[13,3,13,23],[15,3,15,23],[14,3,14,23],[11,3,12,23]]}
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[null,null,null,"Resource Savings Calculator: Reduction of Low-Value Laboratory Tests"]
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[null,null,null,"This economic tool was developed by CADTH to assist decision-makers considering the impact of reducing the use of five low value lab tests identified by Choosing Wisely Canada. The objective is to estimate the potential savings associated if the utilization of these five tests are reduced. Although outside the scope of this tool, by quantifying the potential resource savings, this may provide laboratories with insights on the magnitude of savings expected that could potentially be reinvested towards higher-value laboratory tests to further improve the quality of patient care. "]
[]
[null,null,null,"The tool is provided for estimation purposes only and does not constitute any policy advice."]
[null,null,null,"This tool provides a standardized workbook that estimates the cost and analyzer time impact associated with reductions in lab test ordering. A four step process is introduced in which users must populate some input parameters, as relevant to their institutions. A fifth step (optional) exists for users who are interested in exploring the resource impact of reordering lab tests when abnormal findings are found in the original low-value laboratory tests. For inputs populated by CADTH, additional validation of these parameters within the \"Inputs-\" worksheets is required to ensure the impact calculator produces results that accurately reflect the user's institutional setting."]
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[null,null,null,"How to Use this Excel Tool"]
[]
[null,null,null,"Navigation: To Navigate through this tool, use the buttons at the top of each worksheet or the worksheet tabs at the bottom of the screen. On the five \"Inputs-\" worksheets, review (and edit if necessary) the value of each input parameter. After reviewing all input values in these worksheets, view the results of the analysis on the \"Results\" worksheet."]
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[null,null,null,"Enable macros: To simplify the viewing of this tool, and to restore defaults, CADTH has employed macros. In order to ensure the full functionality of the tool, users must enable macros. If macros are not enabled,  some steps may not be displayed."]
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[null,null,null,"Model Legend: Default values for each modifiable input parameter are shown on the respective \"Inputs-\" worksheets within this tool. Users may enter alternate values in the blue cells within this tool, which will be used automatically throughout the tool's calculations. If alternative data are used, use the \"Restore Inputs\" button on the \"Inputs-\" worksheets to restore the original default values in the model. Note that clicking Restore Defaults on any Inputs sheet will restore ALL default inputs, across all input sheets."]
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[null,null,null,null,null,null,"Fixed input or formula cell - user should not modify"]
[]
[null,null,null,null,null,null,"User-modifiable cell where the user can input alternative value. "]
[null,null,null,null,null,null,"Note: Where default values are defined, user input values will overide default values."]
[]
[null,null,null,null,null,null,"User-modifiable cell where the user can select an alternative value from a dropdown menu"]
[null,null,null,null,null,null,"Note: Where default values are defined, user input values will overide default values."]
[]
[null,null,null,null,"Error",null,"There may be instances where the tool is used incorrectly and is expected to produce erroneous results. In such instances, either an \"Error\" message or cells with red font are programmed to appear."]
[]
[null,null,null,null,null,null,"Restoring defaults will be applied throughout this tool (i.e. all user-input values will be erased and default values, where set by CADTH, will be adopted)."]
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[null,null,null,"Saving the Model: As with any file in Excel, this tool must be saved if any changes are made that need to be retained. Multiple versions of the tool may be saved to handle different scenarios or input parameters. Using File/Save As allows the user to save multiple versions of the tool under different file names."]

{"sheet":"Overview","index":1,"n_rows":39,"n_cols":4,"rows_kept":39,"cut":false,"hidden":false,"merged":[[54,2,54,10],[46,2,46,10],[44,2,44,10],[48,2,48,10],[49,2,49,10],[51,2,51,10],[11,3,11,19],[15,3,15,20],[16,3,16,20],[17,3,17,20],[52,2,52,10],[21,3,21,20],[22,3,22,20],[26,3,26,20],[24,3,24,20],[23,3,23,20],[25,3,25,20]]}
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[null,null,"Calculator Overview"]
[]
[null,null,"This sheet provides an overivew of the tool, key assumptions and abbreviations."]
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[null,null,"Overview"]
[]
[null,null,"Objective","To estimate the potential resource impact of reducing the use of 5 low-value lab tests:   \n\n- AST, including decoupling of routinely coupled AST/ALT\n- Urea, including decoupling of Urea/Creatinine \n- CK-MB, when troponin is available\n- PTT, including decoupling of routinely coupled PT/INR/PTT\n- Serum Folate "]
[null,null,"Perspective","Canadian public hospital lab setting"]
[null,null,"Time Horizon","2 years"]
[null,null,"Discounting & Inflation","Over the two year time horizon, it was assumed that costs would neither be discounted or inflated"]
[null,null,"Costs","Total direct costs for AST, Urea, CK-MB: Supplies and reagent\nTotal direct costs for PTT: Supplies and reagent, compensation (UPP)\nTotal direct costs for Serum Folate: Supplies and reagent, compensation (MOS, MP, UPP), sundry, equipment, buildings/grounds, receiving and accessioning\n\n"]
[null,null,"Outcomes","Total direct costs and total analyzer time (analysis time and reporting time)"]
[null,null,"Description","The resource impact was estimated through a comparison of two hypothetical scenarios:\n\n- Scenario 1: The institution's cost and resource use based on current annual volumes of the 5 lab tests\n- Scenario 2: The institution's cost and resource use based on the hypothetical reductions in the annual volume of the 5 lab tests "]
[]
[null,null,"Key Assumptions"]
[]
[null,null,"Direct cost savings: coupled tests","It was assumed that, for coupled tests, the main driver of direct cost savings would be in the form of reagent/supply costs. This is because the test that these tests are coupled to will be processed on the same analyzer, so other costs associated with these tests are not expected to change. In addition, since PTT testing can require manual technician support, the cost of that support was also included."]
[null,null,"Direct cost savings: standalone tests","For standalone tests, it was assumed that the entire direct cost of the test would be saved if these tests were reduced."]
[null,null,"Analyzer and reporting time: CK-MB","Analyzer time estimates were not available for CK-MB. Therefore, analyzer time was set to be equal to AST. Reporting time was set to be equal to other labs (2.5 minutes)"]
[null,null,"Cost savings associated with repeating an abnormal test (exploratory analysis)","It was assumed that when a coupled test is abnormal, the entire direct cost of the test will be incurred if the test is reordered. This is based on the assumption that had the test not been abnormal, no further testing of this type would be required. If additional tests are required, including a repeat of the coupled test or additional labs tests to investigate an abnormal finding, this approach could underestimate costs associated with repeating abnormal lab tests."]
[null,null,"Frequency that an abnromal test will be repeated (exploratory analysis)","Data informing reordering practices for abnormal lab tests were not available. Therefore, based on clinical expert panel consensus, it was assumed that when a test is unexpectedly abnormal, it will be repeated 75% of the time"]
[null,null,"Implementation","This tool does not include the cost and time of implementation to reduce the use of these 5 low-value lab tests. As such, the potential savings estimated using this tool may be overestimated if the expected cost and time required to implement the change is high.  "]
[]
[null,null,"Abbreviations"]
[]
[null,null,"AST","Aspartate aminotransferase"]
[null,null,"CK-MB","Creatine kinase-MB"]
[null,null,"EORLA","Eastern Ontario Regional Laboratory Association\t"]
[null,null,"INR","International normalized ratio"]
[null,null,"MOS","Management and Office Support (clerical and management staff)"]
[null,null,"MP","Medical Practitioner or Medical & Scientific staff (in the context of lab, pathologists and scientific such as biochemists, microbiologists, etc.)"]
[null,null,"PT","Prothrombin time "]
[null,null,"PTT","Partial thromboplastin time \t"]
[null,null,"UPP","Unit Producing Personnel (in the context of lab, these are all the staff that are lab technicians or Medical Laboratory Technologists) "]

{"sheet":"Instructions","index":2,"n_rows":57,"n_cols":9,"rows_kept":57,"cut":false,"hidden":false,"merged":[[9,2,10,15]]}
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[null,null,"Instructions"]
[]
[null,null,"This sheet provides an overview of the steps required to derive a resource  impact estimate. "]
[null,null,"For steps that say define (Step 1), users MUST populate values. Although default values have been provided, these are unlikely to be appropriate for your jurisdiction."]
[null,null,"For steps that say validate (Steps 2 to 4), default values have been provided. Users should validate that the values reflect their jurisdictional context. If the default values are not appropriate for your jurisdiction, users can define alternatives."]
[]
[]
[null,null,"Step 1.  Define current test volumes in your institution"]
[null,null,"In step 1, users must define the current volume of lab tests being conducted in their institution in a world where there are no reductions or changes to lab test ordering. "]
[null,null,"Defaults have been provided, however, these are unlikely to reflect your jurisdiction. Therefore, for the most accurate resource-saving estimates, users must define current testing volumes."]
[]
[null,null,"Step 2.  Validate percent reductions in testing "]
[null,null,"In step 2, users have two options to specify reductions in the low value lab-tests."]
[null,null,"In the 'Percent reduction' approach, users should validate the default percent reductions in lab testing expected to occur in a world where there are policy or institutional changes to lab test ordering. Users may enter alternative percent reductions in testing if the defaults provided are not appropriate for their jurisdictional context."]
[null,null,"In the 'Volume of lab tests' approach, users must define the annual volumes of tests expected to occur in a world where there are policy or institutional changes to lab test ordering."]
[]
[null,null,"Step 3.  Validate direct lab test costs"]
[null,null,"In step 3, users should validate default direct lab testing costs provided. Users may enter alternative direct costs if defaults provided are not appropriate for their jurisdictional context."]
[]
[null,null,"Step 4. Validate analyzer time."]
[null,null,"In step 4, users should validate default analyzer and reporting times provided. Users may enter alternative analyzer and reporting times if defaults provided are not appropriate for their jurisdictional context."]
[]
[null,null,"Optional Step"]
[null,null,"The tool has the ability to estimate direct lab testing costs associated with investigating abnormal test findings occurring in the 5 low-value lab tests"]
[null,null,"Note that this step is optional: impact results will be populated for direct costs and analyzer times with or without consideration of this step."]
[]
[null,null,"Step 5. Validate the costs of reordering abnormal tests. "]
[null,null,"In step 5, users should validate default percentages of abnormal tests, default percentage of test re-ordering and default direct costs associated with re-ordering."]
[null,null,"Users may enter alternative percentages and direct costs if defaults provided are not appropriate for their jurisdictional context."]
[]
[null,null,"Would you like to explore the potential cost savings associated with re-ordering abnormal labs?"]
[]
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[]
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[null,null,null,null,null,null,null,null,1]

{"sheet":"Inputs-Current test volumes","index":3,"n_rows":55,"n_cols":29,"rows_kept":55,"cut":false,"hidden":false,"merged":[[15,7,16,16],[23,7,24,16],[30,7,34,9],[48,4,48,5],[47,4,47,5],[12,4,12,5],[38,4,38,5],[13,4,13,5],[39,4,39,5],[27,4,27,5],[28,4,28,5]]}
[]
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[null,null,"Inputs: Current Lab Test Volume"]
[]
[null,null,"1. Define the current volume of lab tests being conducted in your institution."]
[null,null,"The first step required is to estimate the current volume of tests being conducted in your institution (i.e., the status quo). Note that this is to reflect current volumes in a world where there are no reductions or changes to lab test ordering. "]
[null,null,"Default lab test volumes have been provided. Users may adjust the default values by their insitutiton's total bed days occupied per annum. "]
[null,null,"Additionally, to ensure current lab test volume reflects their institution, users can also manually enter the test volumes for 2021 and 2022 based on institutional records and projections. "]
[]
[null,null,null,null,"Default",null,null,"Source/Notes"]
[null,null,null,null,"Number of tests annually"]
[null,null,"Test",null,2021,2022]
[null,null,"Urea",null,{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,5,MATCH($C16,'Central NS test numbers'!$B$3:$K$3,0))","v":118039},{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,6,MATCH($C16,'Central NS test numbers'!$B$3:$K$3,0))","v":114191},null,"Default values for 2021 are based on total annual tests conducted in two inpatient sites at the Queen Elizabeth II Health Sciences Centre (Halifax Infirmary and Victoria General)"]
[null,null,"AST",null,{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,5,MATCH($C17,'Central NS test numbers'!$B$3:$K$3,0))","v":29246},{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,6,MATCH($C17,'Central NS test numbers'!$B$3:$K$3,0))","v":30970}]
[null,null,"CK-MB",null,{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,5,MATCH($C18,'Central NS test numbers'!$B$3:$K$3,0))","v":0},{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,6,MATCH($C18,'Central NS test numbers'!$B$3:$K$3,0))","v":0},null,"The total bed days occupied per annum was about 330,000 for both sites combined."]
[null,null,"PTT",null,{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,5,MATCH($C19,'Central NS test numbers'!$B$3:$K$3,0))","v":51577},{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,6,MATCH($C19,'Central NS test numbers'!$B$3:$K$3,0))","v":51435},null,"Default values for 2022 were based on linear projections of test volumes from 2018 to 2021."]
[null,null,"Serum Folate",null,{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,5,MATCH($C20,'Central NS test numbers'!$B$3:$K$3,0))","v":1603},{"$f":"INDEX('Central NS test numbers'!$B$3:$K$9,6,MATCH($C20,'Central NS test numbers'!$B$3:$K$3,0))","v":1635}]
[]
[]
[null,null,"1. a) Would you like to adjust the volume of default labs conducted annually to your institution based on your institution's total bed days occupied per annum?"]
[null,null,null,null,null,null,null,"Note: It is not required to adjust default volumes by their hospital bed days. In the following step, users can enter the volume of lab tests in their institution. "]
[]
[null,null,"Please enter the total bed days occupied per annum "]
[]
[null,null,null,null,"Default Values Adjusted by Institutional Bed Days"]
[null,null,null,null,"Number of tests annually"]
[null,null,"Test",null,2021,2022]
[null,null,"Urea",null,{"$f":"IF(Switch_beddayadjustment=\"\",E16,E16*Adjusting_multiplier)","v":118039},114191,null,{"$f":"IF(AND(Switch_beddayadjustment=\"Yes\",Range_beddays=\"\"),\"Error: Enter your institution's annual bed days to see adjusted default values\",\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Adjusting multiplier",{"$f":"IF(Range_beddays>0,Range_beddays/AC32,100%)","v":1}]
[null,null,"AST",null,29246,30970,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NS health number",330000]
[null,null,"CK-MB",null,0,0]
[null,null,"PTT",null,51577,51435]
[null,null,"Serum Folate",null,1603,1635]
[]
[null,null,"1. b) Enter the number of tests conducted annually in your institution."]
[]
[null,null,null,null,"User Input",null,null,"Source/Notes"]
[null,null,null,null,"Number of tests annually"]
[null,null,"Test",null,2021,2022]
[null,null,"Urea",null,null,null,null,"Enter the total lab test volumes in your institution annually in a world where there is no change to lab ordering practices."]
[null,null,"AST",null,null,null,null,"If a lab is not currently being used in your institution, enter 0 for that lab volume."]
[null,null,"CK-MB"]
[null,null,"PTT"]
[null,null,"Serum Folate",null,null,null,null,"Note: User input values will override defaults, including default values that have been adjusted by institutional bed days (if applicable)."]
[null,null,null,null,{"$f":"IF(AND(Switch_beddayadjustment=\"Yes\",SUM(E42:E46)=0),\"\",IF((COUNTBLANK(E42:E46)<>0),\"Error: Users must enter volumes for all lab tests for 2021. If a lab is not currently being used in your institution, enter 0 for that lab volume.\",\"\"))","v":"Error: Users must enter volumes for all lab tests for 2021. If a lab is not currently being used in your institution, enter 0 for that lab volume."},{"$f":"IF(AND(Switch_beddayadjustment=\"Yes\",SUM(E42:F46)=0),\"\",IF(AND(SUM(E42:E46)>0,SUM(F42:F46)=0),\"Error: Users must enter volumes for 2022; otherwise default values for 2022 listed above will be used\",IF((COUNTBLANK(F42:F46)<>0),\"Error: Users must enter volumes for all lab tests for 2022. If a lab is not currently being used in your institution, enter 0 for that lab volume.\",\"\")))","v":"Error: Users must enter volumes for all lab tests for 2022. If a lab is not currently being used in your institution, enter 0 for that lab volume."}]
[null,null,null,null,"Current Value"]
[null,null,null,null,"Number of tests annually"]
[null,null,"Test",null,2021,2022]
[null,null,"Urea",null,{"$f":"IF(E42=\"\",IF($F$24=\"Yes\",E31,E16),E42)","v":118039},114191]
[null,null,"AST",null,29246,30970]
[null,null,"CK-MB",null,0,0]
[null,null,"PTT",null,51577,51435]
[null,null,"Serum Folate",null,1603,1635]

{"sheet":"Inputs-Reductions in testing","index":4,"n_rows":70,"n_cols":9,"rows_kept":70,"cut":false,"hidden":false,"merged":[[53,5,53,6],[54,5,54,6],[62,5,62,6],[63,5,63,6],[44,5,44,6],[45,5,45,6],[8,2,9,18],[35,5,35,6],[17,5,17,6],[20,8,22,13],[36,5,36,6],[26,5,26,6],[27,5,27,6],[18,5,18,6],[24,8,25,13]]}
[]
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[null,null,"Inputs: Anticipated Reduction in Lab Test Volume"]
[]
[null,null,"2. Validate the anticipated reductions lab testing volumes at your institution."]
[null,null,"The second step is to define the anticipated volume of lab test in a world where there are policy or institutional changes to lab test ordering. This is the future state that has not yet been implemented in your institution, so it should reflect the anticipated reductions in lab tests associated with policy changes being considered. "]
[]
[null,null,"First, users will select how they would like to define the anticipated changes in lab tests (step 2a). Second, based on the selected approach, users will validate default values provided by CADTH and enter alternative values where appropriate."]
[]
[null,null,"2. a) How would you like to define a change in lab test utilization?"]
[null,null,"Select approach:",null,null,null,null,null,"Users have two options to enter the desired change in lab test utilization. "]
[null,null,null,null,null,null,null,null,"i) CADTH has populated default percent reductions in lab tests based on the literature and clinical expert opinion."]
[null,null,null,null,null,null,null,null,"ii) Institutions can enter the expected volume of tests that will be conducted annually."]
[]
[null,null,"Volume approach",null,null,"User Input",null,null,"Source/Notes"]
[null,null,null,null,null,"Number of tests conducted annually"]
[null,null,"Test",null,null,2021,2022]
[null,null,"Urea",null,null,null,null,null,"If undertaking a volume approach, users must enter the annual volumes of tests expected to be conducted in their institution in a world with a policy change to reduce tests."]
[null,null,"AST"]
[null,null,"CK-MB"]
[null,null,"PTT",null,null,null,null,null,"If volumes are not entered, no impact results will be generated. "]
[null,null,"Serum Folate",null,null,null,null,null,"If no lab volume was entered in the current testing scenario, the input cell will appear blocked out as testing volumes are already 0. "]
[]
[null,null,"Percent reduction approach",null,null,"Default"]
[null,null,null,null,null,"Percent reduction in lab tests "]
[null,null,"Test",null,null,2021,2022,null,"Source/Notes"]
[null,null,"Urea",null,null,0.95,0.95,null,"According to the clinical expert panel, 5% of the time the coupled test (creatinine and urea) would be indicated"]
[null,null,"AST",null,null,0.9,0.9,null,"According to the clinical expert panel, 10% of the time the coupled test (ALT and AST) would be indicated"]
[null,null,"CK-MB",null,null,1,1,null,"Assumption: CK-MB would no longer be used in centres with troponin available"]
[null,null,"PTT",null,null,0.75,0.75,null,"According to the clinical expert panel, PTT will be needed 25% of the time."]
[null,null,"Serum Folate",null,null,0.95,0.95,null,"Informed by  MacMillan et al. (2018) and validated by clinical expert panel. "]
[]
[null,null,null,null,null,"User Input",null,null,"Source/Notes"]
[null,null,null,null,null,"Percent reduction in lab tests "]
[null,null,"Test",null,null,2021,2022]
[null,null,"Urea",null,null,null,null,null,"Users can enter alternative percent reductions by year."]
[null,null,"AST"]
[null,null,"CK-MB"]
[null,null,"PTT"]
[null,null,"Serum Folate"]
[]
[null,null,null,null,null,"Current Value"]
[null,null,null,null,null,"Percent reduction in lab tests "]
[null,null,"Test",null,null,2021,2022]
[null,null,"Urea",null,null,{"$f":"IF(F39=\"\",F30,F39)","v":0.95},{"$f":"IF(G39=\"\",G30,G39)","v":0.95}]
[null,null,"AST",null,null,{"$f":"IF(F40=\"\",F31,F40)","v":0.9},{"$f":"IF(G40=\"\",G31,G40)","v":0.9}]
[null,null,"CK-MB",null,null,{"$f":"IF(F41=\"\",F32,F41)","v":1},{"$f":"IF(G41=\"\",G32,G41)","v":1}]
[null,null,"PTT",null,null,{"$f":"IF(F42=\"\",F33,F42)","v":0.75},{"$f":"IF(G42=\"\",G33,G42)","v":0.75}]
[null,null,"Serum Folate",null,null,{"$f":"IF(F43=\"\",F34,F43)","v":0.95},{"$f":"IF(G43=\"\",G34,G43)","v":0.95}]
[]
[null,null,null,null,null,"Current Value"]
[null,null,null,null,null,"Volume Approach"]
[null,null,null,null,null,2021,2022]
[null,null,"Urea",null,null,{"$f":"IFERROR(100%-F21/'Inputs-Current test volumes'!E51,0)","v":1},{"$f":"IFERROR(100%-G21/'Inputs-Current test volumes'!F51,0)","v":1}]
[null,null,"AST",null,null,{"$f":"IFERROR(100%-F22/'Inputs-Current test volumes'!E52,0)","v":1},{"$f":"IFERROR(100%-G22/'Inputs-Current test volumes'!F52,0)","v":1}]
[null,null,"CK-MB",null,null,{"$f":"IFERROR(100%-F23/'Inputs-Current test volumes'!E53,0)","v":0},{"$f":"IFERROR(100%-G23/'Inputs-Current test volumes'!F53,0)","v":0}]
[null,null,"PTT",null,null,{"$f":"IFERROR(100%-F24/'Inputs-Current test volumes'!E54,0)","v":1},{"$f":"IFERROR(100%-G24/'Inputs-Current test volumes'!F54,0)","v":1}]
[null,null,"Serum Folate",null,null,{"$f":"IFERROR(100%-F25/'Inputs-Current test volumes'!E55,0)","v":1},{"$f":"IFERROR(100%-G25/'Inputs-Current test volumes'!F55,0)","v":1}]
[]
[null,null,null,null,null,"Current Value"]
[null,null,null,null,null,"Choice of approach"]
[null,null,null,null,null,2021,2022]
[null,null,"Urea",null,null,{"$f":"IF(Switch_Labtestutilization=\"Volume of lab tests\",F57,F48)","v":0.95},{"$f":"IF(Switch_Labtestutilization=\"Volume of lab tests\",G57,G48)","v":0.95}]
[null,null,"AST",null,null,0.9,0.9]
[null,null,"CK-MB",null,null,1,1]
[null,null,"PTT",null,null,0.75,0.75]
[null,null,"Serum Folate",null,null,0.95,0.95]

{"sheet":"Inputs-Direct costs","index":5,"n_rows":44,"n_cols":10,"rows_kept":44,"cut":false,"hidden":false,"merged":[[35,9,36,16],[24,9,25,20],[9,2,10,10],[13,2,14,10]]}
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[null,null,"Inputs: Direct Costs"]
[]
[null,null,"3. Validate direct lab costs."]
[null,null,"The third step of the tool is to define direct costs associated with the test. Default direct costs have been populated. Users may replace these unit costs with their own institutional costs."]
[null,null,"Direct costs are separated by tests that are being decoupled (AST, Urea, CK-MB and PTT) and those ordered as standalone tests based on expert feedback that the direct cost savings associated with reductions in these tests are influenced by whether they are coupled."]
[]
[]
[null,null,"3. a) Coupled tests"]
[null,null,"Feedback from the panel of clinical experts and a review of the literature indicated that, for coupled tests, the main savings associated with de-coupling will come from the reagents required to conduct the test. In addition, since PTT testing can require manual technician support, the cost of that support was also included."]
[]
[]
[null,null,"Test",null,null,"User Input","Default ","Current Value",null,"Source/Notes"]
[null,null,"Chemistry tests (direct cost include reagent and supply costs per test)"]
[null,null,"Urea",null,null,null,{"$f":"'EORLA Cost data'!H30","v":0.04},{"$f":"IF(F19=\"\",G19,F19)","v":0.04},null,"EORLA reference labs; 2022-23 pricing "]
[null,null,"AST",null,null,null,{"$f":"'EORLA Cost data'!H12","v":0.04},{"$f":"IF(F20=\"\",G20,F20)","v":0.04},null,"EORLA reference labs; 2022-23 pricing "]
[null,null,"CK-MB",null,null,null,4,{"$f":"IF(F21=\"\",G21,F21)","v":4},null,"Data informing CK-MB reagent/supply costs was not available. According to clinical expert panel consensus. "]
[]
[null,null,"Coagulation tests (direct costs include reagent and supply costs per test and unit producing personnel costs per test)"]
[null,null,"PTT"]
[null,null,"Supply and reagent cost per test",null,null,null,{"$f":"'EORLA Cost data'!H66","v":1.26},{"$f":"IF(F25=\"\",G25,F25)","v":1.26},null,"EORLA reference labs; 2022-23 pricing. Unit producing personnel costs are required for PTT as this test can involve a hands-on lab technician component. To explore cost-savings for PTT associated with reagent costs alone, enter 0 in the user input cell."]
[null,null,"Unit Producing Personnel",null,null,null,{"$f":"'EORLA Cost data'!H64","v":2.4700000000000002},{"$f":"IF(F26=\"\",G26,F26)","v":2.4700000000000002}]
[null,null,"Total Direct Costs for PTT",null,null,null,{"$f":"IF(F27=\"\",H25+H26,G25+G26)","v":3.7300000000000004},{"$f":"IF(F27=\"\",G27,F27)","v":3.7300000000000004},null,"Alternatively, users can manually enter a total direct cost per test for PTT."]
[]
[null,null,"3. b) Standalone tests"]
[null,null,"It is assumed that if serum folate is not ordered, the entire direct cost of the Serum Folate test will be saved. "]
[null,null,"For serum folate, direct costs include compensation (MOS, MP, UPP),  supplies and reagents, sundry, equipment, buildings/grounds, receiving and accessioning."]
[null,null,"Default direct costs per test have been populated, along with a total direct cost for serum folate. Users may update the line-item component costs of the folate test, or update total direct folate costs to align with their institution."]
[]
[null,null,"Serum Folate",null,null,"User Input","Default ","Current Value",null,"Source/Notes"]
[null,null,"Compensation - Management and Office Support",null,null,null,{"$f":"'EORLA Cost data'!H44","v":0.19},{"$f":"IF(F35=\"\",G35,F35)","v":0.19},null,"EORLA reference labs; 2022-23 pricing "]
[null,null,"Compensation - Medical Practitioner  ",null,null,null,{"$f":"'EORLA Cost data'!H45","v":0.15},0.15,null,"If line item is not expected to be saved with a reduction in serum folate testing in your institution, enter 0 for that line item."]
[null,null,"Compensation - Unit Producing Personnel ",null,null,null,{"$f":"'EORLA Cost data'!H46","v":0.86},0.86]
[null,null,"Contracted out services",null,null,null,{"$f":"'EORLA Cost data'!H47","v":0},0]
[null,null,"Supply and reagent",null,null,null,{"$f":"'EORLA Cost data'!H48","v":0.4},0.4]
[null,null,"Sundry expense",null,null,null,{"$f":"'EORLA Cost data'!H49","v":0.02},0.02]
[null,null,"Equipment expense",null,null,null,{"$f":"'EORLA Cost data'!H50","v":7.0000000000000007E-2},7.0000000000000007E-2]
[null,null,"Buildings / Grounds expense",null,null,null,{"$f":"'EORLA Cost data'!H51","v":0},0]
[null,null,"Receiving & accessioning",null,null,null,{"$f":"'EORLA Cost data'!H52","v":0.56000000000000005},0.56000000000000005]
[null,null,"Total",null,null,null,{"$f":"IF(F44=\"\",SUM(H35:H43),SUM(G35:G43))","v":2.25},2.25,null,"Default total costs will be updated with user's entry. Alternatively, users can manually enter a total direct cost for serum folate."]

{"sheet":"Inputs-Analyzer Time","index":6,"n_rows":32,"n_cols":11,"rows_kept":32,"cut":false,"hidden":false,"merged":[[14,10,14,22],[27,4,27,8],[12,4,12,8],[11,4,11,8],[19,4,19,8],[20,4,20,8],[26,4,26,8],[22,10,22,18],[15,10,15,18]]}
[]
[]
[]
[]
[]
[null,null,"Inputs-Analyzer time"]
[]
[null,null,"4. Validate analyzer time."]
[null,null,"The fourth step of the tool is to validate the analyzer time associated with the five lab tests. "]
[null,null,"Default analyzer times per test have been populated. Users may enter alternative analyzer times with their own institutional data."]
[]
[null,null,null,null,"Default",null,null,null,null,null,"Notes/Source"]
[null,null,null,null,"Test"]
[null,null,"Time per test in minutes",null,"Urea","AST","CK-MB","PTT","Serum Folate"]
[null,null,"Analysis time",null,8,10,{"$f":"F15","v":10},{"$f":"AVERAGE(5.5,15)","v":10.25},43,null,"Clinical expert panel. Estimates were not available for CK-MB, therefore, analyzer time was assumed to be equal to AST.  Default values for urea, PTT and serum folate were derived from a standard in-lab analyzer"]
[null,null,"Reporting time",null,2.5,2.5,2.5,2.5,2.5,null,"Clinical expert panel. Reporting time when within auto-validation limits was between 2 to 3 minutes, therefore, 2.5 minutes was assumed as a default."]
[null,null,"Total",null,{"$f":"IF(E25=\"\",SUM(E30:E31),SUM(E15:E16))","v":10.5},12.5,12.5,{"$f":"IF(H25=\"\",SUM(H30:H31),SUM(H15:H16))","v":12.75},{"$f":"IF(I25=\"\",SUM(I30:I31),SUM(I15:I16))","v":45.5},null,"The total default value will change if users input analyzer and/or reporting time under the user input table."]
[]
[]
[null,null,null,null,"User Input",null,null,null,null,null,"Notes/Source"]
[null,null,null,null,"Test"]
[null,null,"Time per test in minutes",null,"Urea","AST","CK-MB","PTT","Serum Folate"]
[null,null,"Analysis time",null,null,null,null,null,null,null,"Users may enter alternative analyzer times associated with their institution. If analyzer time or reporting time is not expected to be saved with the reduction of a given lab test, enter 0. "]
[null,null,"Reporting time"]
[null,null,"Total",null,null,null,null,null,null,null,"Total time will be updated with user's entry. Alternatively, users can manually enter a total analysis time."]
[]
[null,null,null,null,"Current Value"]
[null,null,null,null,"Test"]
[null,null,"Time in minutes",null,"Urea","AST","CK-MB","PTT","Serum Folate"]
[null,null,"Analyzer time",null,{"$f":"IF(E23=\"\",E15,E23)","v":8},{"$f":"IF(F23=\"\",F15,F23)","v":10},10,10.25,43]
[null,null,"Reporting time",null,{"$f":"IF(E24=\"\",E16,E24)","v":2.5},2.5,2.5,2.5,2.5]
[null,null,"Total",null,{"$f":"IF(E25=\"\",E17,E25)","v":10.5},{"$f":"IF(F25=\"\",F17,F25)","v":12.5},{"$f":"IF(G25=\"\",G17,G25)","v":12.5},{"$f":"IF(H25=\"\",H17,H25)","v":12.75},{"$f":"IF(I25=\"\",I17,I25)","v":45.5}]

{"sheet":"Inputs-Abnormal tests","index":7,"n_rows":47,"n_cols":9,"rows_kept":47,"cut":false,"hidden":false,"merged":[[40,4,40,6],[14,2,14,7],[28,4,28,6],[17,4,17,6],[8,2,10,14],[30,8,34,16]]}
[]
[]
[]
[]
[]
[null,null,"Inputs-Exploratory Analysis Abnormal Tests Costs"]
[]
[null,null,"5. Validate costs of reordering abnormal tests"]
[null,null,"Clinical panel feedback indicated that additional resources are often used investigating abnormal test findings. If a lab is unexpectedly abnormal (i.e., a  test to be decoupled is abnormal but its coupled counterpart is normal), clinicians may re-order the abnormal test and/or additional tests to validate and investigate the abnormal lab.These unexpected instances are being considered as this could present additional cost savings associated with lab test reductions."]
[]
[]
[null,null,"Note that in this example, only the direct costs of re-ordering tests are considered; impacts on analyzer time are not examined. "]
[null,null,"A three step approach follows to estimate the cost of following up on abnormal lab results among the tests that were identified to be reduced."]
[]
[null,null,"5. a) Validate the percentage of time the lab test will be unexpectedly abnormal."]
[null,null,"In this step, the instances where the tests to be reduced are abnormal are defined. "]
[]
[null,null,"Test",null,"Percentage of time the test is unexpectedly abnormal "]
[null,null,null,null,"User Input","Default","Current Value",null,"Notes/Source"]
[null,null,"Urea",null,null,0.15,{"$f":"IF(E20=\"\",F20,E20)","v":0.15},null,"Clinical expert panel based on 2021 data from a single institution. When urea and creatinine are ordered together, urea may be abnormal ~15% of the time that creatinine is normal. "]
[null,null,"AST",null,null,0.1,{"$f":"IF(E21=\"\",F21,E21)","v":0.1},null,"Clinical expert panel based on 2021 data from a single institution. When AST and ALT are ordered together, AST may be abnormal 10% of the time that ALT is normal. "]
[null,null,"CK-MB",null,null,7.0000000000000007E-2,{"$f":"IF(E22=\"\",F22,E22)","v":7.0000000000000007E-2},null,"Sahedo et al. (2021). When CK-MB and troponin are ordered together, ~7% of the time its normal troponin with abnormal CK-MB. "]
[null,null,"PTT",null,null,0.15,{"$f":"IF(E23=\"\",F23,E23)","v":0.15},null,"Clinical expert panel based on 2021 data from a single institution. When PTT and PT/INR are ordered together, PTT may be abnormal 15% of the time that PT/INR is normal. "]
[null,null,"Serum Folate",null,null,0.01,{"$f":"IF(E24=\"\",F24,E24)","v":0.01},null,"Clinical expert panel. "]
[]
[null,null,"5. b) Define the percentage of time a test will be repeated"]
[null,null,"In order to calculate the costs of following up on abnormal test results, the percentage of time an abnormal test will be repeated must be defined. "]
[]
[null,null,"Test",null,"Percentage of time test will be repeated"]
[null,null,null,null,"User Input","Default","Current Value",null,"Notes/Source"]
[null,null,"Urea",null,null,0.75,{"$f":"IF(E31=\"\",F31,E31)","v":0.75},null,"Data informing reordering practices was not available. Therefore, based on clinical expert panel consensus, it was assumed that when a test is unexpectedly abnormal, 75% of the time the test will be repeated."]
[null,null,"AST",null,null,0.75,{"$f":"IF(E32=\"\",F32,E32)","v":0.75}]
[null,null,"CK-MB",null,null,0.75,{"$f":"IF(E33=\"\",F33,E33)","v":0.75}]
[null,null,"PTT",null,null,0.75,{"$f":"IF(E34=\"\",F34,E34)","v":0.75}]
[null,null,"Serum Folate",null,null,0.75,{"$f":"IF(E35=\"\",F35,E35)","v":0.75}]
[]
[null,null,"5. c) Validate the direct cost savings associated with the repeating of the test"]
[null,null,"It was assumed that when a coupled test is abnormal, the entire direct cost of the test will be incurred if the test is reordered. This is based on the assumption that had the test not been abnormal, no further testing of this type would be required."]
[null,null,"Note: This could be an underestimate of costs if the coupled test is also ordered or if a clinician orders further lab tests to investigate the abnormal finding."]
[]
[null,null,null,null,"Total direct cost of test"]
[null,null,null,null,"User Input","Default","Current Value"]
[null,null,"Urea",null,null,{"$f":"'EORLA Cost data'!H25","v":1.37},{"$f":"IF(E43=\"\",F43,E43)","v":1.37},null,"Source: EORLA reference labs; 2022-23 pricing "]
[null,null,"AST",null,null,{"$f":"'EORLA Cost data'!H7","v":1.37},{"$f":"IF(E44=\"\",F44,E44)","v":1.37},null,"Source: EORLA reference labs; 2022-23 pricing "]
[null,null,"CK-MB",null,null,4,{"$f":"IF(E45=\"\",F45,E45)","v":4},null,"Data informing CK-MB direct costs was not available. According to clinical expert panel consensus. "]
[null,null,"PTT",null,null,{"$f":"'EORLA Cost data'!H62","v":4.59},{"$f":"IF(E46=\"\",F46,E46)","v":4.59},null,"Source: EORLA reference labs; 2022-23 pricing "]
[null,null,"Serum Folate",null,null,{"$f":"'EORLA Cost data'!H43","v":2.2400000000000002},{"$f":"IF(E47=\"\",F47,E47)","v":2.2400000000000002},null,"Source: EORLA reference labs; 2022-23 pricing "]

{"sheet":"Results","index":8,"n_rows":63,"n_cols":26,"rows_kept":63,"cut":false,"hidden":false,"merged":[[22,23,22,24],[32,23,32,24],[37,21,39,21],[43,23,43,24],[54,23,54,24],[37,3,39,3],[37,12,39,12],[43,14,43,15],[54,14,54,15],[40,4,40,5],[51,4,51,5],[10,2,10,4],[12,5,12,6],[22,14,22,15],[32,14,32,15],[32,5,32,6],[20,2,20,4],[22,5,22,6],[62,4,62,5],[40,13,40,14],[51,13,51,14],[62,13,62,14],[40,22,40,23],[51,22,51,23],[62,22,62,23],[43,5,43,6],[54,5,54,6]]}
[]
[]
[]
[]
[]
[null,null,"Results"]
[]
[null,null,"This worksheet presents the results of the impact of reducing the five lab tests identified as being of low value by CWC. "]
[null,null,"Detailed resource impact results are presented first. Totals for the world with and without reductions to lab test volumes are presented to the right of the resource impact results.  "]
[]
[null,null,"Summary table: Resource Impact  "]
[]
[null,null,null,null,null,"Year "]
[null,null,null,null,"Resource Impact",2021,2022,"2-Year Total"]
[null,null,null,null,"Potential cost savings",{"$f":"F40","v":-153251.40800000002},{"$f":"G40","v":-152838.40299999999},{"$f":"H40","v":-306089.81099999999}]
[null,null,null,null,"Potential incremental analyzer time savings (hours)",{"$f":"F51","v":-34482.521041666667},{"$f":"G51","v":-34166.463124999995},-68648.984166666662]
[null,null,null,null,"Exploratory analysis: Potential cost savings from avoiding repeated abnormal tests",{"$f":"F62","v":-39988.035592499997},{"$f":"G62","v":-39529.559924999994},{"$f":"H62","v":-79517.595517499984}]
[null,null,null,null,"*Note: Negative values reflect cost savings"]
[]
[]
[null,null,"Detailed Results: Resource Impact  ",null,null,null,null,null,null,null,null,"Detailed Results: World without reduction to low-value lab tests",null,null,null,null,null,null,null,null,"Detailed Results: World with reduction to low-value lab tests"]
[]
[null,null,null,null,null,"Year ",null,null,null,null,null,null,null,null,"Year ",null,null,null,null,null,null,null,null,"Year "]
[null,null,null,null,"Number of test savings",2021,2022,"2-Year Total",null,null,null,null,null,"Annual test volumes",2021,2022,"2-Year Total",null,null,null,null,null,"Annual test volumes",2021,2022,"2-Year Total"]
[null,null,null,null,"Urea",{"$f":"'Bkg-Impact Results'!D11","v":-112137.04999999999},{"$f":"'Bkg-Impact Results'!E11","v":-108481.45},{"$f":"SUM(F25:G25)","v":-220618.5},null,null,null,null,null,"Urea",{"$f":"'Bkg-Ref scenario'!D11","v":118039},{"$f":"'Bkg-Ref scenario'!E11","v":114191},{"$f":"SUM(O25:P25)","v":232230},null,null,null,null,null,"Urea",{"$f":"'Bkg-ND scenario'!D11","v":5901.9500000000053},{"$f":"'Bkg-ND scenario'!E11","v":5709.5500000000047},{"$f":"'Bkg-ND scenario'!F11","v":11611.500000000011}]
[null,null,null,null,"AST",{"$f":"'Bkg-Impact Results'!D12","v":-26321.4},{"$f":"'Bkg-Impact Results'!E12","v":-27873},{"$f":"SUM(F26:G26)","v":-54194.400000000001},null,null,null,null,null,"AST",{"$f":"'Bkg-Ref scenario'!D12","v":29246},{"$f":"'Bkg-Ref scenario'!E12","v":30970},{"$f":"SUM(O26:P26)","v":60216},null,null,null,null,null,"AST",{"$f":"'Bkg-ND scenario'!D12","v":2924.5999999999995},{"$f":"'Bkg-ND scenario'!E12","v":3096.9999999999991},{"$f":"'Bkg-ND scenario'!F12","v":6021.5999999999985}]
[null,null,null,null,"CK-MB",{"$f":"'Bkg-Impact Results'!D13","v":0},{"$f":"'Bkg-Impact Results'!E13","v":0},{"$f":"SUM(F27:G27)","v":0},null,null,null,null,null,"CK-MB",{"$f":"'Bkg-Ref scenario'!D13","v":0},{"$f":"'Bkg-Ref scenario'!E13","v":0},0,null,null,null,null,null,"CK-MB",{"$f":"'Bkg-ND scenario'!D13","v":0},{"$f":"'Bkg-ND scenario'!E13","v":0},{"$f":"'Bkg-ND scenario'!F13","v":0}]
[null,null,null,null,"PTT",{"$f":"'Bkg-Impact Results'!D14","v":-38682.75},{"$f":"'Bkg-Impact Results'!E14","v":-38576.25},{"$f":"SUM(F28:G28)","v":-77259},null,null,null,null,null,"PTT",{"$f":"'Bkg-Ref scenario'!D14","v":51577},{"$f":"'Bkg-Ref scenario'!E14","v":51435},103012,null,null,null,null,null,"PTT",{"$f":"'Bkg-ND scenario'!D14","v":12894.25},{"$f":"'Bkg-ND scenario'!E14","v":12858.75},{"$f":"'Bkg-ND scenario'!F14","v":25753}]
[null,null,null,null,"Serum Folate",{"$f":"'Bkg-Impact Results'!D15","v":-1522.85},{"$f":"'Bkg-Impact Results'!E15","v":-1553.25},{"$f":"SUM(F29:G29)","v":-3076.1},null,null,null,null,null,"Serum Folate",{"$f":"'Bkg-Ref scenario'!D15","v":1603},{"$f":"'Bkg-Ref scenario'!E15","v":1635},3238,null,null,null,null,null,"Serum Folate",{"$f":"'Bkg-ND scenario'!D15","v":80.150000000000077},{"$f":"'Bkg-ND scenario'!E15","v":81.750000000000071},{"$f":"'Bkg-ND scenario'!F15","v":161.90000000000015}]
[null,null,null,null,"*Note: Negative values reflect cost savings",null,null,null,null,null,null,null,null,"*Note: Negative values reflect cost savings",null,null,null,null,null,null,null,null,"*Note: Negative values reflect cost savings"]
[]
[]
[null,null,null,null,null,"Year ",null,null,null,null,null,null,null,null,"Year ",null,null,null,null,null,null,null,null,"Year "]
[null,null,null,null,"Direct cost savings",2021,2022,"2-Year Total",null,null,null,null,null,"Direct costs",2021,2022,"2-Year Total",null,null,null,null,null,"Direct costs",2021,2022,"2-Year Total"]
[null,null,null,null,"Urea",{"$f":"'Bkg-Impact Results'!D20","v":-4485.482},{"$f":"'Bkg-Impact Results'!E20","v":-4339.2579999999998},{"$f":"'Bkg-Impact Results'!F20","v":-8824.74},{"$f":"SUM(F35:G35)","v":-8824.74},null,null,null,null,"Urea",{"$f":"'Bkg-Ref scenario'!D20","v":4721.5600000000004},{"$f":"'Bkg-Ref scenario'!E20","v":4567.6400000000003},{"$f":"'Bkg-Ref scenario'!F20","v":9289.2000000000007},{"$f":"SUM(O35:P35)","v":9289.2000000000007},null,null,null,null,"Urea",{"$f":"'Bkg-ND scenario'!D20","v":236.0780000000002},{"$f":"'Bkg-ND scenario'!E20","v":228.3820000000002},{"$f":"'Bkg-ND scenario'!F20","v":464.46000000000038}]
[null,null,null,null,"AST",{"$f":"'Bkg-Impact Results'!D21","v":-1052.856},{"$f":"'Bkg-Impact Results'!E21","v":-1114.92},{"$f":"'Bkg-Impact Results'!F21","v":-2167.7759999999998},{"$f":"SUM(F36:G36)","v":-2167.7759999999998},null,null,null,null,"AST",{"$f":"'Bkg-Ref scenario'!D21","v":1169.8399999999999},{"$f":"'Bkg-Ref scenario'!E21","v":1238.8},{"$f":"'Bkg-Ref scenario'!F21","v":2408.64},{"$f":"SUM(O36:P36)","v":2408.64},null,null,null,null,"AST",{"$f":"'Bkg-ND scenario'!D21","v":116.98399999999998},{"$f":"'Bkg-ND scenario'!E21","v":123.87999999999997},{"$f":"'Bkg-ND scenario'!F21","v":240.86399999999995}]
[null,null,null,null,"CK-MB",{"$f":"'Bkg-Impact Results'!D22","v":0},{"$f":"'Bkg-Impact Results'!E22","v":0},{"$f":"'Bkg-Impact Results'!F22","v":0},0,null,null,null,null,"CK-MB",{"$f":"'Bkg-Ref scenario'!D22","v":0},{"$f":"'Bkg-Ref scenario'!E22","v":0},{"$f":"'Bkg-Ref scenario'!F22","v":0},0,null,null,null,null,"CK-MB",{"$f":"'Bkg-ND scenario'!D22","v":0},{"$f":"'Bkg-ND scenario'!E22","v":0},{"$f":"'Bkg-ND scenario'!F22","v":0}]
[null,null,null,null,"PTT",{"$f":"'Bkg-Impact Results'!D23","v":-144286.65750000003},{"$f":"'Bkg-Impact Results'!E23","v":-143889.41250000001},{"$f":"'Bkg-Impact Results'!F23","v":-288176.07000000007},{"$f":"SUM(F38:G38)","v":-288176.07000000007},null,null,null,null,"PTT",{"$f":"'Bkg-Ref scenario'!D23","v":192382.21000000002},{"$f":"'Bkg-Ref scenario'!E23","v":191852.55000000002},{"$f":"'Bkg-Ref scenario'!F23","v":384234.76},384234.76,null,null,null,null,"PTT",{"$f":"'Bkg-ND scenario'!D23","v":48095.552500000005},{"$f":"'Bkg-ND scenario'!E23","v":47963.137500000004},{"$f":"'Bkg-ND scenario'!F23","v":96058.69}]
[null,null,null,null,"Serum Folate",{"$f":"'Bkg-Impact Results'!D24","v":-3426.4124999999999},{"$f":"'Bkg-Impact Results'!E24","v":-3494.8125},{"$f":"'Bkg-Impact Results'!F24","v":-6921.2250000000004},-6921.2250000000004,null,null,null,null,"Serum Folate",{"$f":"'Bkg-Ref scenario'!D24","v":3606.75},{"$f":"'Bkg-Ref scenario'!E24","v":3678.75},{"$f":"'Bkg-Ref scenario'!F24","v":7285.5},7285.5,null,null,null,null,"Serum Folate",{"$f":"'Bkg-ND scenario'!D24","v":180.33750000000018},{"$f":"'Bkg-ND scenario'!E24","v":183.93750000000017},{"$f":"'Bkg-ND scenario'!F24","v":364.27500000000032}]
[null,null,null,null,"Total Direct Costs-Net impact",{"$f":"'Bkg-Impact Results'!D25","v":-153251.40800000002},{"$f":"'Bkg-Impact Results'!E25","v":-152838.40299999999},{"$f":"'Bkg-Impact Results'!F25","v":-306089.81099999999},-306089.81099999999,null,null,null,null,"Total Direct Costs",{"$f":"'Bkg-Ref scenario'!D25","v":201880.36000000002},{"$f":"'Bkg-Ref scenario'!E25","v":201337.74000000002},{"$f":"'Bkg-Ref scenario'!F25","v":403218.10000000003},403218.10000000003,null,null,null,null,"Total Direct Costs",{"$f":"'Bkg-ND scenario'!D25","v":48628.952000000005},{"$f":"'Bkg-ND scenario'!E25","v":48499.337000000007},{"$f":"'Bkg-ND scenario'!F25","v":97128.289000000019}]
[null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(G35:G39)","v":-152838.40299999999},-306089.81100000005,null,null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(P35:P39)","v":201337.74000000002},403218.10000000003,null,null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(Y35:Y39)","v":48499.337000000007},97128.28899999999]
[]
[]
[null,null,null,null,null,"Year ",null,null,null,null,null,null,null,null,"Year ",null,null,null,null,null,null,null,null,"Year "]
[null,null,null,null,"Analyzer time savings (hours)",2021,2022,"2-Year Total",null,null,null,null,null,"Analyzer time (hours)",2021,2022,"2-Year Total",null,null,null,null,null,"Analyzer time (hours)",2021,2022,"2-Year Total"]
[null,null,null,null,"Urea",{"$f":"'Bkg-Impact Results'!D29","v":-19623.983749999999},{"$f":"'Bkg-Impact Results'!E29","v":-18984.253749999996},{"$f":"'Bkg-Impact Results'!F29","v":-38608.237499999996},{"$f":"SUM(F46:G46)","v":-38608.237499999996},null,null,null,null,"Urea",{"$f":"'Bkg-Ref scenario'!D29","v":20656.825000000001},{"$f":"'Bkg-Ref scenario'!E29","v":19983.424999999999},{"$f":"'Bkg-Ref scenario'!F29","v":40640.25},{"$f":"SUM(O46:P46)","v":40640.25},null,null,null,null,"Urea",{"$f":"'Bkg-ND scenario'!D29","v":1032.8412500000009},{"$f":"'Bkg-ND scenario'!E29","v":999.1712500000009},{"$f":"'Bkg-ND scenario'!F29","v":2032.0125000000016}]
[null,null,null,null,"AST",{"$f":"'Bkg-Impact Results'!D30","v":-5483.625},{"$f":"'Bkg-Impact Results'!E30","v":-5806.875},{"$f":"'Bkg-Impact Results'!F30","v":-11290.5},{"$f":"SUM(F47:G47)","v":-11290.5},null,null,null,null,"AST",{"$f":"'Bkg-Ref scenario'!D30","v":6092.916666666667},{"$f":"'Bkg-Ref scenario'!E30","v":6452.083333333333},{"$f":"'Bkg-Ref scenario'!F30","v":12545},{"$f":"SUM(O47:P47)","v":12545},null,null,null,null,"AST",{"$f":"'Bkg-ND scenario'!D30","v":609.29166666666652},{"$f":"'Bkg-ND scenario'!E30","v":645.20833333333314},{"$f":"'Bkg-ND scenario'!F30","v":1254.4999999999995}]
[null,null,null,null,"CK-MB",{"$f":"'Bkg-Impact Results'!D31","v":0},{"$f":"'Bkg-Impact Results'!E31","v":0},{"$f":"'Bkg-Impact Results'!F31","v":0},0,null,null,null,null,"CK-MB",{"$f":"'Bkg-Ref scenario'!D31","v":0},{"$f":"'Bkg-Ref scenario'!E31","v":0},{"$f":"'Bkg-Ref scenario'!F31","v":0},0,null,null,null,null,"CK-MB",{"$f":"'Bkg-ND scenario'!D31","v":0},{"$f":"'Bkg-ND scenario'!E31","v":0},{"$f":"'Bkg-ND scenario'!F31","v":0}]
[null,null,null,null,"PTT",{"$f":"'Bkg-Impact Results'!D32","v":-8220.0843750000004},{"$f":"'Bkg-Impact Results'!E32","v":-8197.453125},{"$f":"'Bkg-Impact Results'!F32","v":-16417.537499999999},-16417.537499999999,null,null,null,null,"PTT",{"$f":"'Bkg-Ref scenario'!D32","v":10960.112499999999},{"$f":"'Bkg-Ref scenario'!E32","v":10929.9375},{"$f":"'Bkg-Ref scenario'!F32","v":21890.05},21890.05,null,null,null,null,"PTT",{"$f":"'Bkg-ND scenario'!D32","v":2740.0281249999998},{"$f":"'Bkg-ND scenario'!E32","v":2732.484375},{"$f":"'Bkg-ND scenario'!F32","v":5472.5124999999998}]
[null,null,null,null,"Serum Folate",{"$f":"'Bkg-Impact Results'!D33","v":-1154.8279166666666},{"$f":"'Bkg-Impact Results'!E33","v":-1177.8812499999999},{"$f":"'Bkg-Impact Results'!F33","v":-2332.7091666666665},-2332.7091666666665,null,null,null,null,"Serum Folate",{"$f":"'Bkg-Ref scenario'!D33","v":1215.6083333333333},{"$f":"'Bkg-Ref scenario'!E33","v":1239.875},{"$f":"'Bkg-Ref scenario'!F33","v":2455.4833333333336},2455.4833333333336,null,null,null,null,"Serum Folate",{"$f":"'Bkg-ND scenario'!D33","v":60.780416666666724},{"$f":"'Bkg-ND scenario'!E33","v":61.993750000000055},{"$f":"'Bkg-ND scenario'!F33","v":122.77416666666679}]
[null,null,null,null,"Total Analyzer time-Net impact",{"$f":"'Bkg-Impact Results'!D34","v":-34482.521041666667},{"$f":"'Bkg-Impact Results'!E34","v":-34166.463124999995},{"$f":"'Bkg-Impact Results'!F34","v":-68648.984166666662},-68648.984166666662,null,null,null,null,"Total Analyzer Time",{"$f":"'Bkg-Ref scenario'!D34","v":38925.462500000001},{"$f":"'Bkg-Ref scenario'!E34","v":38605.320833333331},{"$f":"'Bkg-Ref scenario'!F34","v":77530.783333333326},77530.783333333326,null,null,null,null,"Total Analyzer Time",{"$f":"'Bkg-ND scenario'!D34","v":4442.9414583333337},{"$f":"'Bkg-ND scenario'!E34","v":4438.8577083333339},{"$f":"'Bkg-ND scenario'!F34","v":8881.7991666666676}]
[null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(G46:G50)","v":-34166.463124999995},-68648.984166666662,null,null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(P46:P50)","v":38605.320833333331},77530.78333333334,null,null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(Y46:Y50)","v":4438.8577083333339},8881.7991666666676]
[]
[]
[null,null,null,null,null,"Year ",null,null,null,null,null,null,null,null,"Year ",null,null,null,null,null,null,null,null,"Year "]
[null,null,null,null,"Exploratory result: cost of reordering abnormal tests",2021,2022,"2-Year Total",null,null,null,null,null,"Exploratory result: cost of reordering abnormal tests",2021,2022,"2-Year Total",null,null,null,null,null,"Exploratory result: cost of reordering abnormal tests",2021,2022,"2-Year Total"]
[null,null,null,null,"Urea",{"$f":"'Bkg-Impact Results'!D38","v":-17283.122831249995},{"$f":"'Bkg-Impact Results'!E38","v":-16719.703481249999},{"$f":"'Bkg-Impact Results'!F38","v":-34002.826312499994},{"$f":"SUM(F57:G57)","v":-34002.826312499994},null,null,null,null,"Urea",{"$f":"'Bkg-Ref scenario'!D38","v":18192.760875},{"$f":"'Bkg-Ref scenario'!E38","v":17599.687875},{"$f":"'Bkg-Ref scenario'!F38","v":35792.448749999996},{"$f":"SUM(O57:P57)","v":35792.448749999996},null,null,null,null,"Urea",{"$f":"'Bkg-ND scenario'!D38","v":909.63804375000075},{"$f":"'Bkg-ND scenario'!E38","v":879.98439375000066},{"$f":"'Bkg-ND scenario'!F38","v":1789.6224375000015}]
[null,null,null,null,"AST",{"$f":"'Bkg-Impact Results'!D39","v":-2704.5238500000009},{"$f":"'Bkg-Impact Results'!E39","v":-2863.9507500000004},{"$f":"'Bkg-Impact Results'!F39","v":-5568.4746000000014},{"$f":"SUM(F58:G58)","v":-5568.4746000000014},null,null,null,null,"AST",{"$f":"'Bkg-Ref scenario'!D39","v":3005.0265000000009},{"$f":"'Bkg-Ref scenario'!E39","v":3182.1675000000005},{"$f":"'Bkg-Ref scenario'!F39","v":6187.1940000000013},{"$f":"SUM(O58:P58)","v":6187.1940000000013},null,null,null,null,"AST",{"$f":"'Bkg-ND scenario'!D39","v":300.50265000000002},{"$f":"'Bkg-ND scenario'!E39","v":318.21674999999999},{"$f":"'Bkg-ND scenario'!F39","v":618.71939999999995}]
[null,null,null,null,"CK-MB",{"$f":"'Bkg-Impact Results'!D40","v":0},{"$f":"'Bkg-Impact Results'!E40","v":0},{"$f":"'Bkg-Impact Results'!F40","v":0},0,null,null,null,null,"CK-MB",{"$f":"'Bkg-Ref scenario'!D40","v":0},{"$f":"'Bkg-Ref scenario'!E40","v":0},{"$f":"'Bkg-Ref scenario'!F40","v":0},0,null,null,null,null,"CK-MB",{"$f":"'Bkg-ND scenario'!D40","v":0},{"$f":"'Bkg-ND scenario'!E40","v":0},{"$f":"'Bkg-ND scenario'!F40","v":0}]
[null,null,null,null,"PTT",{"$f":"'Bkg-Impact Results'!D41","v":-19974.805031249998},{"$f":"'Bkg-Impact Results'!E41","v":-19919.811093749995},{"$f":"'Bkg-Impact Results'!F41","v":-39894.616124999993},-39894.616124999993,null,null,null,null,"PTT",{"$f":"'Bkg-Ref scenario'!D41","v":26633.073374999996},{"$f":"'Bkg-Ref scenario'!E41","v":26559.748124999995},{"$f":"'Bkg-Ref scenario'!F41","v":53192.821499999991},53192.821499999991,null,null,null,null,"PTT",{"$f":"'Bkg-ND scenario'!D41","v":6658.2683437499991},{"$f":"'Bkg-ND scenario'!E41","v":6639.9370312499987},{"$f":"'Bkg-ND scenario'!F41","v":13298.205374999998}]
[null,null,null,null,"Serum Folate",{"$f":"'Bkg-Impact Results'!D42","v":-25.583880000000001},{"$f":"'Bkg-Impact Results'!E42","v":-26.094600000000003},{"$f":"'Bkg-Impact Results'!F42","v":-51.678480000000008},-51.678480000000008,null,null,null,null,"Serum Folate",{"$f":"'Bkg-Ref scenario'!D42","v":26.930400000000002},{"$f":"'Bkg-Ref scenario'!E42","v":27.468000000000004},{"$f":"'Bkg-Ref scenario'!F42","v":54.398400000000009},54.398400000000009,null,null,null,null,"Serum Folate",{"$f":"'Bkg-ND scenario'!D42","v":1.3465200000000015},{"$f":"'Bkg-ND scenario'!E42","v":1.3734000000000013},{"$f":"'Bkg-ND scenario'!F42","v":2.7199200000000028}]
[null,null,null,null,"Total costs",{"$f":"'Bkg-Impact Results'!D43","v":-39988.035592499997},{"$f":"'Bkg-Impact Results'!E43","v":-39529.559924999994},{"$f":"'Bkg-Impact Results'!F43","v":-79517.595517499984},-79517.595517499984,null,null,null,null,"Total costs",{"$f":"'Bkg-Ref scenario'!D43","v":47857.79114999999},{"$f":"'Bkg-Ref scenario'!E43","v":47369.071499999998},{"$f":"'Bkg-Ref scenario'!F43","v":95226.862649999995},95226.862649999995,null,null,null,null,"Total costs",{"$f":"'Bkg-ND scenario'!D43","v":7869.7555574999997},{"$f":"'Bkg-ND scenario'!E43","v":7839.5115749999995},{"$f":"'Bkg-ND scenario'!F43","v":15709.267132499999}]
[null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(G57:G61)","v":-39529.559924999994},-79517.595517499984,null,null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(P57:P61)","v":47369.071499999998},95226.862649999995,null,null,null,null,null,"*Note: Negative values reflect cost savings",null,{"$f":"SUM(Y57:Y61)","v":7839.5115749999995},15709.267132499999]

{"sheet":"Appendices and References","index":9,"n_rows":12,"n_cols":3,"rows_kept":12,"cut":false,"hidden":false,"merged":[]}
[]
[]
[]
[]
[]
[null,null,"References and Appendices"]
[]
[null,null,"Worksheets to the right of this sheet contain background calculations."]
[]
[null,null,"Reference List"]
[]
[null,null,"Sahadeo, Prajna A., et al. \"The Best of Both Worlds: Eliminating Creatine Kinase-Muscle/Brain (CK-MB) Testing in the Emergency Department Leads to Lower Costs Without Missed Clinical Diagnoses.\" Cureus 13.5 (2021)."]

{"sheet":"Bkg-Ref scenario","index":10,"n_rows":43,"n_cols":9,"rows_kept":43,"cut":false,"hidden":false,"merged":[[35,7,35,8],[26,3,26,4],[34,1,34,4],[35,3,35,4],[1,1,3,3],[8,3,8,4],[7,1,7,4],[16,1,16,4],[25,1,25,4],[17,3,17,4]]}
[]
[null,"Reference Scenario Results"]
[]
[]
[]
[null,"Backend calculations estimating total market size and costs in the reference scenario. "]
[]
[null,"Market Size"]
[null,null,null,"Number of tests annually"]
[null,"Test",null,2021,2022]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"'Inputs-Current test volumes'!E51","v":118039},{"$f":"'Inputs-Current test volumes'!F51","v":114191}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"'Inputs-Current test volumes'!E52","v":29246},{"$f":"'Inputs-Current test volumes'!F52","v":30970}]
[null,"Creatine kinase (CK-MB)",null,{"$f":"'Inputs-Current test volumes'!E53","v":0},{"$f":"'Inputs-Current test volumes'!F53","v":0}]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"'Inputs-Current test volumes'!E54","v":51577},{"$f":"'Inputs-Current test volumes'!F54","v":51435}]
[null,"Serum Folate",null,{"$f":"'Inputs-Current test volumes'!E55","v":1603},{"$f":"'Inputs-Current test volumes'!F55","v":1635}]
[]
[null,"Direct costs"]
[null,null,null,"Direct costs ($)"]
[null,"Test",null,2021,2022,"2 year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"D$11*'Inputs-Direct costs'!$H$19","v":4721.5600000000004},{"$f":"E$11*'Inputs-Direct costs'!$H$19","v":4567.6400000000003},{"$f":"SUM(D20:E20)","v":9289.2000000000007}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"D$12*'Inputs-Direct costs'!$H$20","v":1169.8399999999999},{"$f":"E$12*'Inputs-Direct costs'!$H$20","v":1238.8},{"$f":"SUM(D21:E21)","v":2408.64}]
[null,"Creatine kinase (CK-MB)",null,{"$f":"D$13*'Inputs-Direct costs'!$H$21","v":0},{"$f":"E$13*'Inputs-Direct costs'!$H$21","v":0},0]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"D$14*'Inputs-Direct costs'!$H$27","v":192382.21000000002},{"$f":"E$14*'Inputs-Direct costs'!$H$27","v":191852.55000000002},384234.76]
[null,"Serum Folate",null,{"$f":"D$15*'Inputs-Direct costs'!$H$44","v":3606.75},{"$f":"E$15*'Inputs-Direct costs'!$H$44","v":3678.75},7285.5]
[null,"Total",null,{"$f":"SUM(D20:D24)","v":201880.36000000002},{"$f":"SUM(E20:E24)","v":201337.74000000002},403218.10000000003]
[null,"Analyzer time"]
[null,null,null,"Time in HOURS"]
[null,"Test",null,2021,2022,"2 year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"(D$11*'Inputs-Analyzer Time'!$E$32)/60","v":20656.825000000001},{"$f":"(E$11*'Inputs-Analyzer Time'!$E$32)/60","v":19983.424999999999},{"$f":"SUM(D29:E29)","v":40640.25}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"(D$12*'Inputs-Analyzer Time'!$F$32)/60","v":6092.916666666667},{"$f":"(E$12*'Inputs-Analyzer Time'!$F$32)/60","v":6452.083333333333},{"$f":"SUM(D30:E30)","v":12545}]
[null,"Creatine kinase (CK-MB)",null,{"$f":"(D$13*'Inputs-Analyzer Time'!$G$32)/60","v":0},{"$f":"(E$13*'Inputs-Analyzer Time'!$G$32)/60","v":0},{"$f":"SUM(D31:E31)","v":0}]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"(D$14*'Inputs-Analyzer Time'!$H$32)/60","v":10960.112499999999},{"$f":"(E$14*'Inputs-Analyzer Time'!$H$32)/60","v":10929.9375},{"$f":"SUM(D32:E32)","v":21890.05}]
[null,"Serum Folate",null,{"$f":"(D$15*'Inputs-Analyzer Time'!$I$32)/60","v":1215.6083333333333},{"$f":"(E$15*'Inputs-Analyzer Time'!$I$32)/60","v":1239.875},{"$f":"SUM(D33:E33)","v":2455.4833333333336}]
[null,"Total",null,{"$f":"SUM(D29:D33)","v":38925.462500000001},{"$f":"SUM(E29:E33)","v":38605.320833333331},{"$f":"SUM(D34:E34)","v":77530.783333333326}]
[null,"Cost of retesting for abnormal tests"]
[null,null,null,"Cost ($)",null,null,null,"Background Calc-Abnormal test"]
[null,"Test",null,2021,2022,"2 year total",null,"Test"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"D11*retest_BUN","v":18192.760875},{"$f":"E11*retest_BUN","v":17599.687875},{"$f":"SUM(D38:E38)","v":35792.448749999996},null,"Blood urea nitrogren (BUN)",{"$f":"'Inputs-Abnormal tests'!G20*'Inputs-Abnormal tests'!G31*'Inputs-Abnormal tests'!G43","v":0.15412499999999998}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"D12*retest_AST","v":3005.0265000000009},{"$f":"E12*retest_AST","v":3182.1675000000005},{"$f":"SUM(D39:E39)","v":6187.1940000000013},null,"Aspartate aminotransferase (AST)",{"$f":"'Inputs-Abnormal tests'!G21*'Inputs-Abnormal tests'!G32*'Inputs-Abnormal tests'!G44","v":0.10275000000000002}]
[null,"Creatine kinase (CK-MB)",null,{"$f":"D13*retest_CKMB","v":0},{"$f":"E13*retest_CKMB","v":0},0,null,"Creatine kinase (CK-MB)",{"$f":"'Inputs-Abnormal tests'!G22*'Inputs-Abnormal tests'!G33*'Inputs-Abnormal tests'!G45","v":0.21000000000000002}]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"D14*retest_PTT","v":26633.073374999996},{"$f":"E14*retest_PTT","v":26559.748124999995},53192.821499999991,null,"Partial thromboplastin time (PTT)",{"$f":"'Inputs-Abnormal tests'!G23*'Inputs-Abnormal tests'!G34*'Inputs-Abnormal tests'!G46","v":0.51637499999999992}]
[null,"Serum Folate",null,{"$f":"D15*retest_folate","v":26.930400000000002},{"$f":"E15*retest_folate","v":27.468000000000004},54.398400000000009,null,"Serum Folate",{"$f":"'Inputs-Abnormal tests'!G24*'Inputs-Abnormal tests'!G35*'Inputs-Abnormal tests'!G47","v":1.6800000000000002E-2}]
[null,"Total",null,{"$f":"SUM(D38:D42)","v":47857.79114999999},{"$f":"SUM(E38:E42)","v":47369.071499999998},{"$f":"SUM(D43:E43)","v":95226.862649999995}]

{"sheet":"Bkg-ND scenario","index":11,"n_rows":43,"n_cols":6,"rows_kept":43,"cut":false,"hidden":false,"merged":[[26,3,26,4],[34,1,34,4],[35,3,35,4],[1,1,3,3],[7,1,7,4],[8,3,8,4],[16,1,16,4],[17,3,17,4],[25,1,25,4]]}
[]
[null,"New Policy Scenario Results"]
[]
[]
[]
[null,"Backend calculations estimating total market size and costs in the reductions in testing scenario. "]
[]
[null,"Market Size"]
[null,null,null,"Number of tests annually"]
[null,"Test",null,2021,2022,"2 year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"(100%-'Inputs-Reductions in testing'!F66)*'Inputs-Current test volumes'!E51","v":5901.9500000000053},{"$f":"(100%-'Inputs-Reductions in testing'!G66)*'Inputs-Current test volumes'!F51","v":5709.5500000000047},{"$f":"SUM(D11:E11)","v":11611.500000000011}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"(100%-'Inputs-Reductions in testing'!F67)*'Inputs-Current test volumes'!E52","v":2924.5999999999995},{"$f":"(100%-'Inputs-Reductions in testing'!G67)*'Inputs-Current test volumes'!F52","v":3096.9999999999991},{"$f":"SUM(D12:E12)","v":6021.5999999999985}]
[null,"Creatine kinase (CK-MB)",null,{"$f":"(100%-'Inputs-Reductions in testing'!F68)*'Inputs-Current test volumes'!E53","v":0},{"$f":"(100%-'Inputs-Reductions in testing'!G68)*'Inputs-Current test volumes'!F53","v":0},{"$f":"SUM(D13:E13)","v":0}]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"(100%-'Inputs-Reductions in testing'!F69)*'Inputs-Current test volumes'!E54","v":12894.25},{"$f":"(100%-'Inputs-Reductions in testing'!G69)*'Inputs-Current test volumes'!F54","v":12858.75},{"$f":"SUM(D14:E14)","v":25753}]
[null,"Serum Folate",null,{"$f":"(100%-'Inputs-Reductions in testing'!F70)*'Inputs-Current test volumes'!E55","v":80.150000000000077},{"$f":"(100%-'Inputs-Reductions in testing'!G70)*'Inputs-Current test volumes'!F55","v":81.750000000000071},{"$f":"SUM(D15:E15)","v":161.90000000000015}]
[null,null,null,null,null,0]
[null,"Direct costs"]
[null,null,null,"Direct costs ($)"]
[null,"Test",null,2021,2022,"2 year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"D$11*'Inputs-Direct costs'!$H$19","v":236.0780000000002},{"$f":"E$11*'Inputs-Direct costs'!$H$19","v":228.3820000000002},{"$f":"SUM(D20:E20)","v":464.46000000000038}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"D$12*'Inputs-Direct costs'!$H$20","v":116.98399999999998},{"$f":"E$12*'Inputs-Direct costs'!$H$20","v":123.87999999999997},{"$f":"SUM(D21:E21)","v":240.86399999999995}]
[null,"Creatine kinase (CK-MB)",null,{"$f":"D$13*'Inputs-Direct costs'!$H$21","v":0},{"$f":"E$13*'Inputs-Direct costs'!$H$21","v":0},{"$f":"SUM(D22:E22)","v":0}]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"D$14*'Inputs-Direct costs'!$H$27","v":48095.552500000005},{"$f":"E$14*'Inputs-Direct costs'!$H$27","v":47963.137500000004},96058.69]
[null,"Serum Folate",null,{"$f":"D$15*'Inputs-Direct costs'!$H$44","v":180.33750000000018},{"$f":"E$15*'Inputs-Direct costs'!$H$44","v":183.93750000000017},364.27500000000032]
[null,"Total",null,{"$f":"SUM(D20:D24)","v":48628.952000000005},{"$f":"SUM(E20:E24)","v":48499.337000000007},97128.289000000019]
[null,"Analyzer time",null,null,null,0]
[null,null,null,"Time in HOURS"]
[null,"Test",null,2021,2022,"2 year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"(D$11*'Inputs-Analyzer Time'!$E$32)/60","v":1032.8412500000009},{"$f":"(E$11*'Inputs-Analyzer Time'!$E$32)/60","v":999.1712500000009},{"$f":"SUM(D29:E29)","v":2032.0125000000016}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"(D$12*'Inputs-Analyzer Time'!$F$32)/60","v":609.29166666666652},{"$f":"(E$12*'Inputs-Analyzer Time'!$F$32)/60","v":645.20833333333314},1254.4999999999995]
[null,"Creatine kinase (CK-MB)",null,{"$f":"(D$13*'Inputs-Analyzer Time'!$G$32)/60","v":0},{"$f":"(E$13*'Inputs-Analyzer Time'!$G$32)/60","v":0},0]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"(D$14*'Inputs-Analyzer Time'!$H$32)/60","v":2740.0281249999998},{"$f":"(E$14*'Inputs-Analyzer Time'!$H$32)/60","v":2732.484375},5472.5124999999998]
[null,"Serum Folate",null,{"$f":"(D$15*'Inputs-Analyzer Time'!$I$32)/60","v":60.780416666666724},{"$f":"(E$15*'Inputs-Analyzer Time'!$I$32)/60","v":61.993750000000055},122.77416666666679]
[null,"Total",null,{"$f":"SUM(D29:D33)","v":4442.9414583333337},{"$f":"SUM(E29:E33)","v":4438.8577083333339},8881.7991666666676]
[null,"Cost of retesting for abnormal tests"]
[null,null,null,"Time in mins"]
[null,"Test",null,2021,2022,"2 year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"D11*retest_BUN","v":909.63804375000075},{"$f":"E11*retest_BUN","v":879.98439375000066},{"$f":"SUM(D38:E38)","v":1789.6224375000015}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"D12*retest_AST","v":300.50265000000002},{"$f":"E12*retest_AST","v":318.21674999999999},618.71939999999995]
[null,"Creatine kinase (CK-MB)",null,{"$f":"D13*retest_CKMB","v":0},{"$f":"E13*retest_CKMB","v":0},0]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"D14*retest_PTT","v":6658.2683437499991},{"$f":"E14*retest_PTT","v":6639.9370312499987},13298.205374999998]
[null,"Serum Folate",null,{"$f":"D15*retest_folate","v":1.3465200000000015},{"$f":"E15*retest_folate","v":1.3734000000000013},2.7199200000000028]
[null,"Total",null,{"$f":"SUM(D38:D42)","v":7869.7555574999997},{"$f":"SUM(E38:E42)","v":7839.5115749999995},15709.267132499999]

{"sheet":"Bkg-Impact Results","index":12,"n_rows":43,"n_cols":15,"rows_kept":43,"cut":false,"hidden":false,"merged":[[35,9,35,10],[13,7,13,13],[16,7,16,10],[17,9,17,10],[25,7,25,10],[26,9,26,10],[34,7,34,10],[26,3,26,4],[34,1,34,4],[35,3,35,4],[1,1,3,3],[7,1,7,4],[8,3,8,4],[16,1,16,4],[17,3,17,4],[25,1,25,4]]}
[]
[null,"New Policy Scenario Results"]
[]
[]
[]
[null,"Backend calculations estimating total market size and costs in resource impact scenario. "]
[]
[null,"Market Size"]
[null,null,null,"Number of tests annually"]
[null,"Test",null,2021,2022]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"'Bkg-ND scenario'!D11-'Bkg-Ref scenario'!D11","v":-112137.04999999999},{"$f":"'Bkg-ND scenario'!E11-'Bkg-Ref scenario'!E11","v":-108481.45}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"'Bkg-ND scenario'!D12-'Bkg-Ref scenario'!D12","v":-26321.4},{"$f":"'Bkg-ND scenario'!E12-'Bkg-Ref scenario'!E12","v":-27873}]
[null,"Creatine kinase (CK-MB)",null,{"$f":"'Bkg-ND scenario'!D13-'Bkg-Ref scenario'!D13","v":0},{"$f":"'Bkg-ND scenario'!E13-'Bkg-Ref scenario'!E13","v":0}]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"'Bkg-ND scenario'!D14-'Bkg-Ref scenario'!D14","v":-38682.75},{"$f":"'Bkg-ND scenario'!E14-'Bkg-Ref scenario'!E14","v":-38576.25},null,null,"CHECK"]
[null,"Serum Folate",null,{"$f":"'Bkg-ND scenario'!D15-'Bkg-Ref scenario'!D15","v":-1522.85},{"$f":"'Bkg-ND scenario'!E15-'Bkg-Ref scenario'!E15","v":-1553.25}]
[]
[null,"Direct costs",null,null,null,null,null,"Direct costs",null,null,null,null,"check"]
[null,null,null,"Direct costs ($)",null,null,null,null,null,"Direct costs ($)"]
[null,"Test",null,2021,2022,"Two year total",null,"Test",null,2021,2022,"Two year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"D$11*'Inputs-Direct costs'!$H$19","v":-4485.482},{"$f":"E$11*'Inputs-Direct costs'!$H$19","v":-4339.2579999999998},{"$f":"SUM(D20:E20)","v":-8824.74},null,"Blood urea nitrogren (BUN)",null,{"$f":"'Bkg-ND scenario'!D20-'Bkg-Ref scenario'!D20","v":-4485.482},{"$f":"'Bkg-ND scenario'!E20-'Bkg-Ref scenario'!E20","v":-4339.2579999999998},{"$f":"SUM(J20:K20)","v":-8824.74},{"$f":"IF(D20=J20,TRUE,FALSE)","v":true},true,true]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"D$12*'Inputs-Direct costs'!$H$20","v":-1052.856},{"$f":"E$12*'Inputs-Direct costs'!$H$20","v":-1114.92},{"$f":"SUM(D21:E21)","v":-2167.7759999999998},null,"Aspartate aminotransferase (AST)",null,{"$f":"'Bkg-ND scenario'!D21-'Bkg-Ref scenario'!D21","v":-1052.856},{"$f":"'Bkg-ND scenario'!E21-'Bkg-Ref scenario'!E21","v":-1114.92},{"$f":"SUM(J21:K21)","v":-2167.7759999999998},true,true,true]
[null,"Creatine kinase (CK-MB)",null,{"$f":"D$13*'Inputs-Direct costs'!$H$21","v":0},{"$f":"E$13*'Inputs-Direct costs'!$H$21","v":0},0,null,"Creatine kinase (CK-MB)",null,{"$f":"'Bkg-ND scenario'!D22-'Bkg-Ref scenario'!D22","v":0},{"$f":"'Bkg-ND scenario'!E22-'Bkg-Ref scenario'!E22","v":0},0,true,true,true]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"D$14*'Inputs-Direct costs'!$H$27","v":-144286.65750000003},{"$f":"E$14*'Inputs-Direct costs'!$H$27","v":-143889.41250000001},-288176.07000000007,null,"Partial thromboplastin time (PTT)",null,{"$f":"'Bkg-ND scenario'!D23-'Bkg-Ref scenario'!D23","v":-144286.65750000003},{"$f":"'Bkg-ND scenario'!E23-'Bkg-Ref scenario'!E23","v":-143889.41250000001},-288176.07000000007,true,true,true]
[null,"Serum Folate",null,{"$f":"D$15*'Inputs-Direct costs'!$H$44","v":-3426.4124999999999},{"$f":"E$15*'Inputs-Direct costs'!$H$44","v":-3494.8125},-6921.2250000000004,null,"Serum Folate",null,{"$f":"'Bkg-ND scenario'!D24-'Bkg-Ref scenario'!D24","v":-3426.4124999999999},{"$f":"'Bkg-ND scenario'!E24-'Bkg-Ref scenario'!E24","v":-3494.8125},-6921.2250000000004,true,true,true]
[null,"Total",null,{"$f":"SUM(D20:D24)","v":-153251.40800000002},{"$f":"SUM(E20:E24)","v":-152838.40299999999},-306089.81099999999,null,"Total",null,{"$f":"SUM(J20:J24)","v":-153251.40800000002},{"$f":"SUM(K20:K24)","v":-152838.40299999999},-306089.81099999999,true,true,true]
[null,"Analyzer time",null,null,null,null,null,"Analyzer time"]
[null,null,null,"Time in hours",null,null,null,null,null,"Time in hours"]
[null,"Test",null,2021,2022,"Two year total",null,"Test",null,2021,2022,"Two year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"(D$11*'Inputs-Analyzer Time'!$E$32)/60","v":-19623.983749999999},{"$f":"(E$11*'Inputs-Analyzer Time'!$E$32)/60","v":-18984.253749999996},{"$f":"SUM(D29:E29)","v":-38608.237499999996},null,"Blood urea nitrogren (BUN)",null,{"$f":"'Bkg-ND scenario'!D29-'Bkg-Ref scenario'!D29","v":-19623.983749999999},{"$f":"'Bkg-ND scenario'!E29-'Bkg-Ref scenario'!E29","v":-18984.25375},{"$f":"SUM(J29:K29)","v":-38608.237500000003},{"$f":"IF(D29=J29,TRUE,FALSE)","v":true},true,true]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"(D$12*'Inputs-Analyzer Time'!$F$32)/60","v":-5483.625},{"$f":"(E$12*'Inputs-Analyzer Time'!$F$32)/60","v":-5806.875},-11290.5,null,"Aspartate aminotransferase (AST)",null,{"$f":"'Bkg-ND scenario'!D30-'Bkg-Ref scenario'!D30","v":-5483.625},{"$f":"'Bkg-ND scenario'!E30-'Bkg-Ref scenario'!E30","v":-5806.875},{"$f":"SUM(J30:K30)","v":-11290.5},true,true,true]
[null,"Creatine kinase (CK-MB)",null,{"$f":"(D$13*'Inputs-Analyzer Time'!$G$32)/60","v":0},{"$f":"(E$13*'Inputs-Analyzer Time'!$G$32)/60","v":0},0,null,"Creatine kinase (CK-MB)",null,{"$f":"'Bkg-ND scenario'!D31-'Bkg-Ref scenario'!D31","v":0},{"$f":"'Bkg-ND scenario'!E31-'Bkg-Ref scenario'!E31","v":0},0,true,true,true]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"(D$14*'Inputs-Analyzer Time'!$H$32)/60","v":-8220.0843750000004},{"$f":"(E$14*'Inputs-Analyzer Time'!$H$32)/60","v":-8197.453125},-16417.537499999999,null,"Partial thromboplastin time (PTT)",null,{"$f":"'Bkg-ND scenario'!D32-'Bkg-Ref scenario'!D32","v":-8220.0843749999985},{"$f":"'Bkg-ND scenario'!E32-'Bkg-Ref scenario'!E32","v":-8197.453125},-16417.537499999999,true,true,true]
[null,"Serum Folate",null,{"$f":"(D$15*'Inputs-Analyzer Time'!$I$32)/60","v":-1154.8279166666666},{"$f":"(E$15*'Inputs-Analyzer Time'!$I$32)/60","v":-1177.8812499999999},-2332.7091666666665,null,"Serum Folate",null,{"$f":"'Bkg-ND scenario'!D33-'Bkg-Ref scenario'!D33","v":-1154.8279166666666},{"$f":"'Bkg-ND scenario'!E33-'Bkg-Ref scenario'!E33","v":-1177.8812499999999},-2332.7091666666665,true,true,true]
[null,"Total",null,{"$f":"SUM(D29:D33)","v":-34482.521041666667},{"$f":"SUM(E29:E33)","v":-34166.463124999995},-68648.984166666662,null,"Total",null,{"$f":"SUM(J29:J33)","v":-34482.521041666667},{"$f":"SUM(K29:K33)","v":-34166.463125000002},-68648.984166666662,true,true,true]
[null,"Cost of retesting for abnormal tests",null,null,null,null,null,"Cost of retesting for abnormal tests"]
[null,null,null,"Time in mins",null,null,null,null,null,"Time in mins"]
[null,"Test",null,2021,2022,"Two year total",null,"Test",null,2021,2022,"Two year total"]
[null,"Blood urea nitrogren (BUN)",null,{"$f":"D11*retest_BUN","v":-17283.122831249995},{"$f":"E11*retest_BUN","v":-16719.703481249999},{"$f":"SUM(D38:E38)","v":-34002.826312499994},null,"Blood urea nitrogren (BUN)",null,{"$f":"'Bkg-Ref scenario'!D38-'Bkg-ND scenario'!D38","v":17283.122831249999},{"$f":"'Bkg-Ref scenario'!E38-'Bkg-ND scenario'!E38","v":16719.703481249999},{"$f":"SUM(J38:K38)","v":34002.826312499994},{"$f":"IF(D38=J38,TRUE,FALSE)","v":false},{"$f":"IF(E38=K38,TRUE,FALSE)","v":false},{"$f":"IF(F38=L38,TRUE,FALSE)","v":false}]
[null,"Aspartate aminotransferase (AST)",null,{"$f":"D12*retest_AST","v":-2704.5238500000009},{"$f":"E12*retest_AST","v":-2863.9507500000004},{"$f":"SUM(D39:E39)","v":-5568.4746000000014},null,"Aspartate aminotransferase (AST)",null,{"$f":"'Bkg-Ref scenario'!D39-'Bkg-ND scenario'!D39","v":2704.5238500000009},{"$f":"'Bkg-Ref scenario'!E39-'Bkg-ND scenario'!E39","v":2863.9507500000004},{"$f":"SUM(J39:K39)","v":5568.4746000000014},{"$f":"IF(D39=J39,TRUE,FALSE)","v":false},false,false]
[null,"Creatine kinase (CK-MB)",null,{"$f":"D13*retest_CKMB","v":0},{"$f":"E13*retest_CKMB","v":0},0,null,"Creatine kinase (CK-MB)",null,{"$f":"'Bkg-Ref scenario'!D40-'Bkg-ND scenario'!D40","v":0},{"$f":"'Bkg-Ref scenario'!E40-'Bkg-ND scenario'!E40","v":0},0,true,true,true]
[null,"Partial thromboplastin time (PTT)",null,{"$f":"D14*retest_PTT","v":-19974.805031249998},{"$f":"E14*retest_PTT","v":-19919.811093749995},-39894.616124999993,null,"Partial thromboplastin time (PTT)",null,{"$f":"'Bkg-Ref scenario'!D41-'Bkg-ND scenario'!D41","v":19974.805031249998},{"$f":"'Bkg-Ref scenario'!E41-'Bkg-ND scenario'!E41","v":19919.811093749995},39894.616124999993,false,false,false]
[null,"Serum Folate",null,{"$f":"D15*retest_folate","v":-25.583880000000001},{"$f":"E15*retest_folate","v":-26.094600000000003},-51.678480000000008,null,"Serum Folate",null,{"$f":"'Bkg-Ref scenario'!D42-'Bkg-ND scenario'!D42","v":25.583880000000001},{"$f":"'Bkg-Ref scenario'!E42-'Bkg-ND scenario'!E42","v":26.094600000000003},51.678480000000008,false,false,false]
[null,null,null,{"$f":"SUM(D38:D42)","v":-39988.035592499997},{"$f":"SUM(E38:E42)","v":-39529.559924999994},-79517.595517499984,null,null,null,{"$f":"SUM(J38:J42)","v":39988.035592499997},{"$f":"SUM(K38:K42)","v":39529.559924999994},79517.595517499984,false,false,false]

{"sheet":"Dropdowns","index":13,"n_rows":16,"n_cols":2,"rows_kept":16,"cut":false,"hidden":false,"merged":[]}
[]
["Hospital type","Acute academic"]
[null,"Community/General "]
[null,"Complex continuing care"]
[null,"Small hospitals"]
[]
["Approach to reduction in lab tests","Percent reduction in test use"]
[null,"Volume of lab tests"]
[]
["Volume for 2022","Assume equal to 2021 volumes"]
[null,"Manually enter 2022 volumes"]
[null,"Based on linear extrapolation of historical data (where possible)"]
[]
[]
[null,"Yes"]
[null,"No"]

{"sheet":"Central NS test numbers","index":14,"n_rows":9,"n_cols":11,"rows_kept":9,"cut":false,"hidden":false,"merged":[]}
[]
[]
[null,"Year","PT_INR","PTT","AST","ALT","Serum Folate","Urea","Cr","CK-MB","Troponin"]
[null,2018,58022,48572,23355,26506,1253,118200,131312,"           0",19071]
[null,2019,54889,46832,25024,27819,1208,114330,128418,0,18321]
[null,2020,52355,48288,26803,29279,1317,110504,139204,0,16185]
[null,2021,55686,51577,29246,31763,1603,118039,139978,0,19169]
["Projections",2022,{"$f":"TREND(C4:C7,$B$4:$B$7,$B$8:$B$9)","v":52852.5},{"$f":"TREND(D4:D7,$B$4:$B$7,$B$8:$B$9)","v":51435},{"$f":"TREND(E4:E7,$B$4:$B$7,$B$8:$B$9)","v":30970},{"$f":"TREND(F4:F7,$B$4:$B$7,$B$8:$B$9)","v":33149.5},{"$f":"TREND(G4:G7,$B$4:$B$7,$B$8:$B$9)","v":1635},{"$f":"TREND(H4:H7,$B$4:$B$7,$B$8:$B$9)","v":114191},{"$f":"TREND(I4:I7,$B$4:$B$7,$B$8:$B$9)","v":143924},null,{"$f":"TREND(K4:K7,$B$4:$B$7,$B$8:$B$9)","v":17726}]
[null,2023,51898.300000000047,52482.100000000093,32915.200000000186,34872.600000000093,1750.8999999999942,113760.09999999998,147602.40000000037,null,17541.799999999988]

{"sheet":"EORLA Cost data","index":15,"n_rows":75,"n_cols":8,"rows_kept":75,"cut":false,"hidden":false,"merged":[[0,0,3,0],[0,1,3,1],[0,2,3,2],[0,3,3,3],[0,5,0,7]]}
["EORLA _ Reference Lab (TOH) ","Source","Type of Expense","Billable Units \n(2018-19)",null,"2022-23 Pricing"]
[]
[null,null,null,null,null,null,null,"Total"]
[null,null,null,null,null,"Fixed","Variable"]
[]
["PG10400 - SGOT (AST)",null,null,147862,null,1.02,0.57000000000000006,1.59]
[null,"Direct",null,null,null,0.8,0.57000000000000006,1.37]
[null,null,"COMPENSATION - MOS",null,null,0.09,0,0.09]
[null,null,"COMPENSATION - MP",null,null,0.15,0,0.15]
[null,null,"COMPENSATION - UPP",null,null,0.45,0,0.46]
[null,null,"CONTRACTED OUT SERVICES",null,null,0,0,0]
[null,null,"SUPPLIES",null,null,0,0.04,0.04]
[null,null,"SUNDRY EXPENSE",null,null,0.01,0,0.01]
[null,null,"EQUIPMENT EXPENSE",null,null,7.0000000000000007E-2,0,7.0000000000000007E-2]
[null,null,"BUILDINGS / GROUNDS EXPENSE",null,null,0,0,0]
[null,null,"RECEIVING & ACCESSIONING",null,null,0.03,0.53,0.56000000000000005]
[null,"Indirect",null,null,null,0.22,0,0.22]
[null,null,"Corporate Loading/Depreciation",null,null,0.18,0,0.18]
[null,null,"Site Administration",null,null,0.01,0,0.01]
[null,null,"Employee Future Benefits",null,null,0.01,0,0.01]
[null,null,"EORLA - LIS",null,null,0.02,0,0.02]
[null,null,null,null,null," "," "," "]
[null,null,null,null,null," "," "," "]
["PG10420 - Urea nitrogen (B.U.N.)",null,null,358555,null,1.02,0.57000000000000006,1.59]
[null,"Direct",null,null,null,0.8,0.57000000000000006,1.37]
[null,null,"COMPENSATION - MOS",null,null,0.09,0,0.09]
[null,null,"COMPENSATION - MP",null,null,0.15,0,0.15]
[null,null,"COMPENSATION - UPP",null,null,0.45,0,0.46]
[null,null,"CONTRACTED OUT SERVICES",null,null,0,0,0]
[null,null,"SUPPLIES",null,null,0,0.04,0.04]
[null,null,"SUNDRY EXPENSE",null,null,0.01,0,0.01]
[null,null,"EQUIPMENT EXPENSE",null,null,7.0000000000000007E-2,0,7.0000000000000007E-2]
[null,null,"BUILDINGS / GROUNDS EXPENSE",null,null,0,0,0]
[null,null,"RECEIVING & ACCESSIONING",null,null,0.03,0.53,0.56000000000000005]
[null,"Indirect",null,null,null,0.22,0,0.22]
[null,null,"Corporate Loading/Depreciation",null,null,0.18,0,0.18]
[null,null,"Site Administration",null,null,0.01,0,0.01]
[null,null,"Employee Future Benefits",null,null,0.01,0,0.01]
[null,null,"EORLA - LIS",null,null,0.02,0,0.02]
[null,null,null,null,null," "," "," "]
[null,null,null,null,null," "," "," "]
["PG10480 - Folate",null,null,18373,null,1.6600000000000001,0.93,2.5900000000000003]
[null,"Direct",null,null,null,1.31,0.93,2.2400000000000002]
[null,null,"COMPENSATION - MOS",null,null,0.19,0,0.19]
[null,null,"COMPENSATION - MP",null,null,0.15,0,0.15]
[null,null,"COMPENSATION - UPP",null,null,0.85,0,0.86]
[null,null,"CONTRACTED OUT SERVICES",null,null,0,0,0]
[null,null,"SUPPLIES",null,null,0,0.4,0.4]
[null,null,"SUNDRY EXPENSE",null,null,0.02,0,0.02]
[null,null,"EQUIPMENT EXPENSE",null,null,7.0000000000000007E-2,0,7.0000000000000007E-2]
[null,null,"BUILDINGS / GROUNDS EXPENSE",null,null,0,0,0]
[null,null,"RECEIVING & ACCESSIONING",null,null,0.03,0.53,0.56000000000000005]
[null,"Indirect",null,null,null,0.35,0,0.35]
[null,null,"Corporate Loading/Depreciation",null,null,0.3,0,0.3]
[null,null,"Site Administration",null,null,0.01,0,0.01]
[null,null,"Employee Future Benefits",null,null,0.01,0,0.01]
[null,null,"EORLA - LIS",null,null,0.03,0,0.03]
[null,null,null,null,null," ","  "," "]
[null,null,null,null,null," "," "," "]
[null,null,null,null,null," "," "," "]
["PG10740 - Partial thromboplastin time",null,null,53548,null,0.90999999999999992,4.2600000000000007,5.17]
[null,"Direct",null,null,null,0.32999999999999996,4.2600000000000007,4.59]
[null,null,"COMPENSATION - MOS",null,null,0.15,0,0.15]
[null,null,"COMPENSATION - UPP",null,null,0,2.4700000000000002,2.4700000000000002]
[null,null,"CONTRACTED OUT SERVICES",null,null,0,0,0]
[null,null,"SUPPLIES",null,null,0,1.26,1.26]
[null,null,"SUNDRY EXPENSE",null,null,0.02,0,0.02]
[null,null,"EQUIPMENT EXPENSE",null,null,0.13,0,0.13]
[null,null,"BUILDINGS / GROUNDS EXPENSE",null,null,0,0,0]
[null,null,"RECEIVING & ACCESSIONING",null,null,0.03,0.53,0.56000000000000005]
[null,"Indirect",null,null,null,0.57999999999999996,0,0.57999999999999996]
[null,null,"Corporate Loading/Depreciation",null,null,0.52,0,0.52]
[null,null,"Site Administration",null,null,0.01,0,0.01]
[null,null,"Employee Future Benefits",null,null,0.01," ",0.01]
[null,null,"EORLA - LIS",null,null,0.04,0,0.04]

{"sheet":"Test time","index":16,"n_rows":9,"n_cols":6,"rows_kept":9,"cut":false,"hidden":false,"merged":[]}
[]
[]
[]
[null,"Test","Analyzer analysis time per test","Reporting time when  within auto-validation limits","Reporting time when outside auto-validation limits*","Reporting time when outside auto-validation limits* MEDIAN"]
[null,"Urea","8 minutes","~2-3 mins","~4- 10 mins",{"$f":"MEDIAN(4,10)","v":7}]
[null,"Folate","43 minutes","~2-3 mins","~4 mins",4]
[null,"AST","10 minutes","~2-3 mins","~4-10 mins",{"$f":"MEDIAN(4,10)","v":7}]
[null,"PTT","5.5- 15 minutes**"]
[null,"CK-MB","Not done in NS"]

{"sheet":"Data Store","index":17,"n_rows":27,"n_cols":18,"rows_kept":27,"cut":false,"hidden":true,"merged":[[0,2,0,6],[18,2,18,8]]}
[null,null,"Cost per test"]
[null,null,"BUN","Folate","PTT","AST","CK-MB",null,"Median Lab Assistant hourly wage"]
[null,"Province"]
[null,"Newfoundland and Labrador","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,29]
[null,"Prince Edward Island","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,25]
[null,"Nova Scotia","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,23.9,null,null,null,null,"User Input","Default ","Current Value",null,"Notes/Source"]
[null,"New Brunswick","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,21.46,null,"Hourly cost of MLA time",null,null,null,{"$f":"INDEX('Data Store'!$I$2:$I$16,MATCH('Data Store'!$E$27,'Data Store'!$B$2:$B$16,0),)","v":29},{"$f":"IF(N7=\"\",O7,N7)","v":29},null,"https://www.jobbank.gc.ca/marketreport/wages-occupation/4214/ca"]
[null,"Quebec","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,29]
[null,"Ontario",1.28,3.11,2.66,1.28,"CK-MB $",null,29]
[null,"Manitoba","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,24.3]
[null,"Saskatchewan","BUN cost","Folate cost",10.199999999999999,"AST$","CK-MB $",null,23.41]
[null,"Alberta",11.91,"Folate cost",16.88,"AST$","CK-MB $",null,28.34]
[null,"British Columbia","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,25]
[null,"Yukon","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,{"$f":"AVERAGE($I$4:$I$13)","v":25.841000000000001},"NA-Average of other jurisdictions"]
[null,"Northwest Territories","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,{"$f":"AVERAGE($I$4:$I$13)","v":25.841000000000001},"NA-Average of other jurisdictions"]
[null,"Nunavut ","BUN cost","Folate cost","PPT $","AST$","CK-MB $",null,25.841000000000001,"NA-Average of other jurisdictions"]
[null,null,null,null,null,null,null,null,"Source: https://www.jobbank.gc.ca/marketreport/wages-occupation/4214/ca "]
[]
[null,null,"Schedule of benefit costs"]
[null,null,"Test",null,null,"User Input","Default ","Current Value",null,"Notes/Source"]
[null,null,"Urea",null,null,null,{"$f":"INDEX('Data Store'!$B$2:$G$16,MATCH('Data Store'!$E$27,'Data Store'!$B$2:$B$16,0),2)","v":"BUN cost"},{"$f":"IF(F21=\"\",G21,F21)","v":"BUN cost"},null,"Based on the provincial schedule of benefits fee."]
[null,null,"Folate",null,null,null,{"$f":"INDEX('Data Store'!$B$2:$G$16,MATCH('Data Store'!$E$27,'Data Store'!$B$2:$B$16,0),3)","v":"Folate cost"},{"$f":"IF(F22=\"\",G22,F22)","v":"Folate cost"},null,"In provinces where SOB weren't identify, Ontario costs were used as defaults."]
[null,null,"Partial thromboplastin time (PTT)",null,null,null,{"$f":"INDEX('Data Store'!$B$2:$G$16,MATCH('Data Store'!$E$27,'Data Store'!$B$2:$B$16,0),4)","v":"PPT $"},{"$f":"IF(F23=\"\",G23,F23)","v":"PPT $"}]
[null,null,"Aspartate aminotransferase (AST)",null,null,null,{"$f":"INDEX('Data Store'!$B$2:$G$16,MATCH('Data Store'!$E$27,'Data Store'!$B$2:$B$16,0),5)","v":"AST$"},{"$f":"IF(F24=\"\",G24,F24)","v":"AST$"}]
[null,null,"Creatine kinase (CK-MB)",null,null,null,{"$f":"INDEX('Data Store'!$B$2:$G$16,MATCH('Data Store'!$E$27,'Data Store'!$B$2:$B$16,0),6)","v":"CK-MB $"},{"$f":"IF(F25=\"\",G25,F25)","v":"CK-MB $"}]
[]
[null,null,"Province",null,"Quebec"]

{"sheet":"Query Indirect costs","index":18,"n_rows":13,"n_cols":10,"rows_kept":13,"cut":false,"hidden":true,"merged":[[6,2,6,8],[9,9,10,15]]}
[]
[]
[]
[]
[null,null,"Inputs-Indirect costs"]
[]
[null,null,"Hospital indirect cost per test"]
[null,null,"Test",null,null,"User Input","Default ","Current Value"]
[null,null,"Urea",null,null,null,0.22,{"$f":"IF(F9=\"\",G9,F9)","v":0.22},null,"Source: EORLA reference labs; 2022-23 pricing "]
[null,null,"Folate",null,null,null,0.35,{"$f":"IF(F10=\"\",G10,F10)","v":0.35},null,"Indirect costs include: corporate loading/deprecipation; site administration; employee future benefits and EORLA LIS"]
[null,null,"Partial thromboplastin time (PTT)",null,null,null,0.57999999999999996,{"$f":"IF(F11=\"\",G11,F11)","v":0.57999999999999996}]
[null,null,"Aspartate aminotransferase (AST)",null,null,null,0.22,{"$f":"IF(F12=\"\",G12,F12)","v":0.22}]
[null,null,"Creatine kinase (CK-MB)",null,null,null,{"$f":"G10","v":0.35},{"$f":"IF(F13=\"\",G13,F13)","v":0.35},null,"CK-MB cost assumed to be equal to folate."]