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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Main Authors: Fumio Omata, Takuro Shimbo, Sachiko Ohde, Gautam A. Deshpande, Tsuguya Fukui
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2017/2453254
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author Fumio Omata
Takuro Shimbo
Sachiko Ohde
Gautam A. Deshpande
Tsuguya Fukui
author_facet Fumio Omata
Takuro Shimbo
Sachiko Ohde
Gautam A. Deshpande
Tsuguya Fukui
author_sort Fumio Omata
collection DOAJ
description 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%.
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spelling doaj-art-ee457283322148c7a70482f561c1e3522025-02-03T01:02:49ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/24532542453254Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic GastritisFumio Omata0Takuro Shimbo1Sachiko Ohde2Gautam A. Deshpande3Tsuguya Fukui4Department of Internal Medicine, St. Luke’s International Hospital, Chuo-Ku, JapanOhta Nishinouchi Hospital, Koriyama, JapanCenter for Clinical Epidemiology, St. Luke’s International University, Chuo-Ku, JapanCenter for Clinical Epidemiology, St. Luke’s International University, Chuo-Ku, JapanDepartment of Internal Medicine, St. Luke’s International Hospital, Chuo-Ku, JapanBackground. 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%.http://dx.doi.org/10.1155/2017/2453254
spellingShingle Fumio Omata
Takuro Shimbo
Sachiko Ohde
Gautam A. Deshpande
Tsuguya Fukui
Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis
Gastroenterology Research and Practice
title Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis
title_full Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis
title_fullStr Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis
title_full_unstemmed Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis
title_short Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis
title_sort cost effectiveness analysis of helicobacter pylori diagnostic methods in patients with atrophic gastritis
url http://dx.doi.org/10.1155/2017/2453254
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