Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton 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 serologic screening prevents nontraumatic fractures in celiac disease

This month's Clinical Gastroenterology & Hepatology investigates the 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 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.

The research team noted that transition probabilities and quality of life estimates were obtained from the literature.

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 universal serologic screening and symptomatic at-risk screening strategies, respectively, corresponding to average quality-adjusted life year gains of 25.511 and 25.515.

For men, the average lifetime costs were $8532 for universal serologic screening
Clinical Gastroenterology and Hepatology

The doctors found that similarly for women, costs were $11,383 and $11,328 for universal serologic screening and symptomatic at-risk screening strategies, respectively, corresponding to quality-adjusted life year gains of 25.74 and 25.75.

Compared with the current standard of care, universal serologic screening 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 universal serologic screening cost-ineffective on the basis of these outcomes.

Dr Park's team commented, "universal serologic screening and symptomatic at-risk screening are similar in lifetime costs and quality of life, although 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 and Hepatol 2013: 11(6) :645-653
26 June 2013

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

 31 March 2015

Advanced search
 31 March 2015 
HCV-HIV co-infection combination therapy
 31 March 2015 
Placement of nasoenteral feeding tubes
 31 March 2015 
Hepatic fat and gallbladder polyps
 30 March 2015 
Minimally invasive approach in colorectal procedures
 30 March 2015 
Prevalence of IBD in USA residents of Indian ancestry
 30 March 2015 
Treatment of pediatric IBD
 27 March 2015 
Screening for fecal incontinence
 27 March 2015 
Deep remission in Crohn's disease
 27 March 2015 
Sexual functioning in IBD
 26 March 2015 
Antimicrobial therapy in cirrhosis with spontaneous bacterial peritonitis
 26 March 2015 
Metformin as a chemopreventive agent for Barrett's
 26 March 2015 
Survival of untreated hepatocellular carcinoma
 25 March 2015 
Genetics and Crohn's disease
 25 March 2015 
Mortality in Barrett’s–related T1 esophageal adenocarcinoma
 25 March 2015 
Cytomegalovirus and IBD
 24 March 2015 
Prevention of colorectal cancer after screening
 24 March 2015 
Functional GI disorders and body mass index
 24 March 2015 
Quality of life in children with fecal incontinence
 23 March 2015 
Fibrosis in NAFLD vs NASH
 23 March 2015 
The unmasking of Whipple's disease
 23 March 2015 
Predicting the quality of colon cancer care
 20 March 2015 
Interventions for eosinophilic esophagitis
 20 March 2015 
Screening for Barrett's esophagus
 20 March 2015 
Colorectal cancer risk and genetic variants
 19 March 2015 
Dedicated care for diverticular disease
 19 March 2015 
Hypnotherapy for IBS
 19 March 2015 
Poor mental and physical health in HCV
 18 March 2015 
Practice guidelines for colorectal polyps
 18 March 2015 
Out-of-hours endoscopy for upper GI bleeding
 18 March 2015 
H. pylori eradication and lipids
 17 March 2015 
H. pylori test-and-treat program and gastric cancer
 17 March 2015 
Adalimumab in Crohn’s disease
 17 March 2015 

Low-dose PPIs and GI bleeding in patients receiving aspirin

 16 March 2015 
Microscopic colitis
 16 March 2015 
Cholestasis of pregnancy with HCV
 16 March 2015 
Hybrid therapy for H. pylori
 13 March 2015 
Medicare patients and payments to gastroenterologists
 13 March 2015 
Appendectomy in ulcerative colitis
 13 March 2015 

Racial disparities in gluten-sensitive problems

 12 March 2015 
Predicting IBD in IBS patients
 12 March 2015 
Patient knowledge of IBS
 12 March 2015 
Nonceliac gluten sensitivity
 11 March 2015 

Prediction of malignant bile duct obstruction

 11 March 2015 
NAFLD–related hepatocellular carcinoma
 11 March 2015 
Assessment of eosinophilic esophagitis
 10 March 2015 
Risk for gastroesophageal reflux symptoms
 10 March 2015 
Poor disease course in pediatric ulcerative colitis
 10 March 2015 
Outcomes in Crohn's therapy
 09 March 2015 
Fibre usage in ulcerative colitis in remission
 09 March 2015 
Risk of C. difficile upon hospital admission
 09 March 2015 
Gastric Cancer detection during GI endosocopy
 06 March 2015 
Steroid therapy for eosinophilic esophagitis
 06 March 2015 
Second anti-TNF in IBD
 06 March 2015 
Efficacy of Hep E vaccine
 05 March 2015 
EPHXI polymorphism and esophageal cancer risk
 05 March 2015 
Infliximab and immunosuppressant therapy in ulcerative colitis
 05 March 2015 
Neuroendocrine carcinoma of the colon and rectum
 04 March 2015 
Multidisciplinary management of rectal cancer
 04 March 2015 
Management of IBD
 04 March 2015 
Progression of Barrett's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us