Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 05 December 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Universal screening prevents hip and vertebral fractures in celiac disease

This month's issue of Clinical Gastroenterology & Hepatology investigates cost-effectiveness of universal serologic screening to prevent nontraumatic hip and vertebral fractures in patients with celiac disease.

News image

Patients with asymptomatic or poorly managed celiac disease can experience bone loss, placing them at risk for hip and vertebral fractures.

Dr Park and colleagues from California, USA analyzed the cost-effectiveness of universal serologic screening (USS) vs symptomatic at-risk screening strategies for celiac disease because of the risk of nontraumatic hip and vertebral fractures if untreated or undiagnosed.

The research team developed a lifetime Markov model of the screening strategies, each with male or female cohorts of 1000 patients who were 12 years old when screening began.

The team screened serum samples for levels of immunoglobulin A, compared with tissue transglutaminase and total immunoglobulin A, and findings were confirmed by mucosal biopsy.

Transition probabilities and quality of life estimates were obtained from the literature.

The average lifetime cost was $8532 for USS
Clinical Gastroenteorlogy & Hepatology

The researchers used generalizable cost estimates and Medicare reimbursement rates, and ran deterministic and probabilistic sensitivity analyses.

For men, the average lifetime costs were $8532 and $8472 for USS and symptomatic at-risk screening strategies, respectively, corresponding to average quality-adjusted life year gains of 25.511 and 25.515.

Similarly for women, costs were $11,383 and $11,328 for USS and symptomatic at-risk screening strategies, respectively, corresponding to quality-adjusted life year gains of 25.74 and 25.75.

The team noted that compared with the current standard of care, USS produced higher average lifetime costs and lower quality of life for each sex.

Deterministic and probabilistic sensitivity analyses showed that the model was robust to realistic changes in all the variables, making USS cost-ineffective on the basis of these outcomes.

Dr Park's team concludes, "USS and symptomatic at-risk screening are similar in lifetime costs and quality of life."

"The current symptomatic at-risk screening strategy was overall more cost-effective in preventing bone loss and fractures among patients with undiagnosed or subclinical disease."

"On the basis of best available supportive evidence, it is more cost-effective to maintain the standard celiac screening practices, although future robust population-based evidence in other health outcomes could be leveraged to reevaluate current screening guidelines."

Clin Gastroenterol Hepatol 2013: 11(6): 645-653
24 May 2013

Go to top of page Email this page Email this page to a colleague

 05 December 2016 
Reducing hospitalization in IBD
 05 December 2016 
Disease mangement in IBD
 05 December 2016 
New biomarkers for IBD diagnosis
 02 December 2016 
Hep E in acute liver failure
 02 December 2016 
Occurrence and severity of alcoholic hepatitis
 02 December 2016 
Food antigen in active eosinophilic esophagitis
 01 December 2016 
Iron deficiency in anemic ulcerative colitis patients
 01 December 2016 
Prognostic factors after paracetamol-induced liver failure
 01 December 2016 
Factors that influence colorectal cancer screening findings
 30 November 2016 
Certolizumab pegol in Crohn's disease
 30 November 2016 
Genetic risk of Crohn's in chronic granulomatous disease
 30 November 2016 
Rifaximin in diarrhea-predominant IBS
 29 November 2016 
Assessing liver steatosis
 29 November 2016 
Colorectal cancer surveillance in ulcerative colitis
 29 November 2016 
Treating Zenker's diverticulum
 28 November 2016 
Complications in celiac disease
 28 November 2016 
Monitoring IBD with mobile technology
 28 November 2016 
Reducing warfarin-related upper GI bleeds
 25 November 2016 
Metal vs plastic stents for pancreatic cancer surgery
 25 November 2016 
Yoga and IBS therapy 
 25 November 2016 
Colorectal cancer screening issues
 24 November 2016 
Partner burden in celiac disease
 24 November 2016 
Fusobacterium nucleatum for colorectal cancer prognosis
 24 November 2016 
PPIS and gastric cancer risk
 23 November 2016 
Diagnosing autoimmune pancreatitis
 23 November 2016 
Readmissions in cirrhosis
 23 November 2016 
Quality assurance standards for colonoscopy
 22 November 2016 
Fatigue in IBD
 22 November 2016 
PPIs and C. diff in ICU 
 22 November 2016 
Bile acid diarrhea in function bowel disorder with diarrhea
 21 November 2016 
Financial incentives and colorectal cancer screening
 21 November 2016 
Pain after endoscopic resection of gastric tumors
 21 November 2016 
Antivirals and chemotherapy in Hep C patients with cancer
 18 November 2016 
Ustekinumab in Crohn’s disease
 18 November 2016 
Colorectal cancer risk and self-reported family history
 18 November 2016 
Antivirals and chemotherapy in Hep C patients with cancer
 17 November 2016 
Liver-related specialty care in patients with Hep C
 17 November 2016 
Risk of overweight in infants
 17 November 2016 
Moderate alcohol consumption and NAFLD
 16 November 2016 
PPI therapy in liver disease
 16 November 2016 
Education in Gastroenterology fellowship
 16 November 2016 
Paternal preconceptional use of anti-TNF-α agents
 15 November 2016 
Novel treatment of NASH 
 15 November 2016 
Physician perspectives on Hep C management
 15 November 2016 
Contraceptives and ulcerative colitis
 14 November 2016 
Cardiovascular risk in NAFLD 
 14 November 2016 
Vit D and NAFLD
 14 November 2016 
Malignancy risk in IBD 
 11 November 2016 
Treatment of Hep C along with opioid agonist therapy
 11 November 2016 
Diabetes and liver cancer risk in Hep C cirrhosis
 11 November 2016 
Biomarker of cirrhosis progression
 10 November 2016 
Testosterone levels and cirrhosis outcomes in men
 10 November 2016 
Improving bowel quality before colonoscopy
 10 November 2016 
Fecal microbiota transplantation and CDI episodes
 09 November 2016 
Minimizing costs of esophagogastroduodenoscopy and colonoscopy
 09 November 2016 
Risk of TB in IBD patients receiving therapy
 09 November 2016 
Liver transplant wait-list and mortality in infants
 08 November 2016 
NSAIDS and risk of Barrett’s
 08 November 2016 
Ferritin levels and NAFLD mortality
 08 November 2016 
Alarms in the diagnosis of colorectal cancer

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us