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- Title
Non-invasive testing for Helicobacter pylori in patients hospitalized with peptic ulcer hemorrhage: a cost-effectiveness analysis.
- Authors
Atreja, Ashish; Fu, Alex Z.; Sanaka, Madhusudan R.; Vargo, John J.
- Abstract
<bold>Purpose: </bold>Guidelines recommend routine invasive screening for Helicobacter pylori in patients with peptic ulcer hemorrhage (PUH). However, compliance with screening remains suboptimal. The aim of this study was to determine if a simplified approach based on noninvasive screening is cost effective in PUH.<bold>Results: </bold>In the base case, post-endoscopy urea breath test (UBT) dominated the invasive testing with 34 fewer hemorrhages and cost savings of $406,600 in a cohort of 10,000 patients. When compliance with invasive testing decreases to 60%, post-endoscopy UBT leads to 109 fewer hemorrhages and cost savings of $1,089,600. The invasive strategy becomes the preferred choice if the sensitivity of UBT reduces to <75%, such as in patients taking proton-pump inhibitors (PPI) before hospitalization.<bold>Conclusions: </bold>Post-endoscopy UBT is cost effective in PPI-naïve patients presenting with PUH. This strategy, once prospectively validated, can prove to be a preferred approach in institutions where compliance with invasive testing is suboptimal.
- Subjects
HELICOBACTER pylori; PEPTIC ulcer; ARTERIAL injuries; BREATH tests; CARBON isotopes; URINALYSIS; PATIENTS; HELICOBACTER disease diagnosis; COST effectiveness; PROTON pump inhibitors; DECISION trees; GASTROSCOPY; HELICOBACTER diseases; HOSPITAL admission &; discharge; HOSPITAL costs; ISOTOPES; SYSTEM analysis; ECONOMICS
- Publication
Digestive Diseases & Sciences, 2010, Vol 55, Issue 5, p1356
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-009-0865-6