Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis.

Background. There are several diagnostic methods for Helicobacter pylori (H. pylori) infection. A cost-effective analysis is needed to decide on the optimal diagnostic method. The aim of this study was to determine a cost-effective diagnostic method in patients with atrophic gastritis (AG). Methods....

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Published in:Gastroenterology Research & Practice pp. 1 - 11
Main Authors: Omata, Fumio, Shimbo, Takuro, Ohde, Sachiko, Deshpande, Gautam A., Fukui, Tsuguya
Format: Journal Article
Published: Wiley-Blackwell 2/23/2017
Online Access:View this record in EBSCOhost
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      dt: 2/23/2017
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        121412679
        10.1155/2017/2453254
        121412679
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        atl: Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis.
      aug:
        au:
          Omata, Fumio
          Shimbo, Takuro
          Ohde, Sachiko
          Deshpande, Gautam A.
          Fukui, Tsuguya
        affil: Department of Internal Medicine, St. Luke’s International Hospital, Chuo-Ku, Japan
      sug:
      ab: Background. There are several diagnostic methods for Helicobacter pylori (H. pylori) infection. A cost-effective analysis is needed to decide on the optimal diagnostic method. The aim of this study was to determine a cost-effective diagnostic method in patients with atrophic gastritis (AG). Methods. A decision-analysis model including seven diagnostic methods was constructed for patients with AG diagnosed by esophagogastroduodenoscopy. Expected values of cost and effectiveness were calculated for each test. Results. If the prevalence of H. pylori in the patients with AG is 85% and CAM-resistant H. pylori is 30%, histology, stool H. pylori antigen (SHPAg), bacterial culture (BC), and urine H. pylori antibody (UHPAb) were dominated by serum H. pylori IgG antibody (SHPAb), rapid urease test (RUT), and urea breath test (UBT). Among three undominated methods, the incremental cost-effective ratios (ICER) of RUT versus SHPAb and UBT versus RUT were $214 and $1914, respectively. If the prevalence of CAM-sensitive H. pylori was less than 55%, BC was not dominated, but its H. pylori eradication success rate was 0.86. Conclusions. RUT was the most cost-effective at the current prevalence of CAM-resistant H. pylori. BC could not be selected due to its poor effectiveness even if CAM-resistant H. pylori was more than 45%.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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