Help
Subscribe


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

 28 August 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 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

 26 August 2016 
Bleeding after endoscopic dissection-induced gastric ulcers
 26 August 2016 
Reasons for premature surveillance colonoscopy
 26 August 2016 
Celiac disease therapeutics
 25 August 2016 
Post-infectious IBS in C. diff
 25 August 2016 
Stool DNA test for colorectal cancer screening
 25 August 2016 
Short-chain fatty acids in mixed refractory constipation
 24 August 2016 
Genetics and therapy response in IBD
 24 August 2016 
Hep B after infant vaccination program
 24 August 2016 
Obeticholic acid for primary biliary cholangitis
 23 August 2016 
Colorectal cancer genetics as biomarkers
 23 August 2016 
Prognostic test for mortality after liver transplant
 23 August 2016 
Postoperative mortality in elderly with IBD
 22 August 2016 
Celiac disease in the elderly
 22 August 2016 
Laparoscopic vs open colectomy databases
 22 August 2016 
Mucosal healing and ulcerative colitis outcomes
 19 August 2016 
Dietary questionnaire for GI clinics
 19 August 2016 
Botox treatment for chronic anal fissure
 19 August 2016 
Myeloid-derived suppressor cells in GI cancers
 18 August 2016 
Gallstone formation determinants
 18 August 2016 
Age disparities in IBD therapy
 18 August 2016 
Seasonal variation in diverticulitis
 17 August 2016 
IBD activity score for routine clinical use
 17 August 2016 
Attitudes to H. pylori in primary care
 17 August 2016 
Nonselective β-blockers and mortality in cirrhosis
 16 August 2016 
Upper GI lesions in adults with IBD
 16 August 2016 
C. difficile infection and mortality when managed by GI surgeons
 16 August 2016 
HCV eradication in cirrhosis
 15 August 2016 
Predicting favorable outcomes in IBD
 15 August 2016 
Scoring system predicted microscopic colitis
 15 August 2016 
Mortality in spontaneous bacterial peritonitis
 12 August 2016 
Recurrence of resected gastric cancer
 12 August 2016 
Screening for pancreatic cancer
 12 August 2016 
Index for diagnostic accuracy of Crohn's
 11 August 2016 
Colorectal neoplasm on surveillance colonoscopies
 11 August 2016 
Bowel disease in primary care patients with bowel symptoms
 11 August 2016 
Diagnosis in covert hepatic encephalopathy
 10 August 2016 
Maintenance therapy for children with eosinophilic esophagitis
 10 August 2016 
Moderate alcohol use and insulin action in HCV
 10 August 2016 
Consensus on the management of GERD
 09 August 2016 
Pancreatitis quality of life instrument
 09 August 2016 
Gallstone disease and NAFLD
 09 August 2016 
Steroid dependency and IBD
 08 August 2016 
Venous thromboembolism in celiac disease
 08 August 2016 
C. diff in IBD 
 08 August 2016 
Gut-directed hypnotherapy vs low FODMAP diet in IBS
 05 August 2016 
Therapy for H.pylori treatment
 05 August 2016 
Obesity and the development of NAFLD
 05 August 2016 
Obesity and CVD in celiac disease
 04 August 2016 
Bleeding after endoscopic resection of colorectal lesions
 04 August 2016 
Novel risk factor for post-ERCP pancreatitis
 04 August 2016 
Ondansetron for children with acute gastroenteritis
 03 August 2016 
Post-colonoscopy complications
 03 August 2016 
IVF in women with IBD
 03 August 2016 
Post-operative pancreatic fistulae after pancreatic surgery
 02 August 2016 
H. pylori in children
 02 August 2016 
Gastric cancer in patients with gastric intestinal metaplasia
 02 August 2016 
Behavioral changes and bariatric surgery
 01 August 2016 
Relapse after cessation of oral antiviral treatment in Hep B
 01 August 2016 
Antimicrobial resistance of H. pylori
 01 August 2016 
Colorectal cancers in IBD

Blackwell Publishing


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