Supporting Information
Table S1  Model inputs: Estimated personnel and time requirements and associated costs for specimen collection options for Pneumocystis pneumonia. *Estimates not available from laboratories; costs estimated by authors. BAL cost does not include cost of intubation. See Appendix S1 for working year and salary assumptions. †Time calculations based on procedure being performed on one patient at a time. 1Oral wash involves patients rinsing their oral cavities with a small volume of sterile saline and gargling for one minute before expectorating into a cup. 2Expectorated sputum involves asking a patient to inhale deeply several times before producing a deep cough from the chest. 3Induced sputum involves inhaling 3% sterile saline for 15–30 min using an ultrasonic nebulizer before asking the patient to expectorate sputum. 4Bronchoalveolar lavage involves instilling fluid into the lung and recovering the fluid using a bronchoscope.
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Table S2  Model inputs: Personnel and time requirements and associated costs for laboratory procedures for diagnosis of Pneumocystis pneumonia. ¥Time estimated from starting sample to result ready to be reported. †Cost for personnel time is estimated as the amount of time a test takes excluding machine running times. We assumed that an average of five samples could be processed concurrently, dividing personnel-time costs by five. *Estimates not available from laboratories; values estimated by authors. CXR: Chest x-ray; DQ: Diff-Quick; GMS: Grocott's Methenamine Silver Stain; TBO: Toluidine Blue O; CW: Calcofluor white stain; IFA: Immunofluorescence microscopy assay; PCR: Polymerase chain reaction; nPCR: nested PCR; rtPCR: real-time (quantitative) PCR.
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Table S3  Model inputs: cost of treatment, treatment failure rate, and prevalence of disease in the population.
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Table S4  Sensitivity analysis: cost per life-year gained with variations in diagnostic procedure cost, sensitivity, specificity, treatment failure rates, and treatment costs. *Neither sensitivity nor specificity was increased beyond a value of 1.00. Procedures which in the base model were 0.90 or greater were capped at 1.00. CXR: Chest x-ray; DQ: Diff-Quick; GMS: Grocott's Methenamine Silver Stain; TBO: Toluidine Blue O; CW: Calcofluor white stain; IFA: Immunofluorescence microscopy assay; PCR: Polymerase chain reaction; nPCR: nested PCR; rtPCR: real-time (quantitative) PCR; Expect. sputum, expectorated sputum.
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Appendix S1  Estimated salaries for laboratory workers, health care workers, and clinicians involved in patient care and diagnosis of PCP.
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