Researchers from Albuquerque, New Mexico assessed the incremental cost-effectiveness of endoscopic procedures in the workup for irritable bowel syndrome (IBS).
Their findings have been reported in the latest issue of Archives of Internal Medicine.
Using the Bayes formula, the team calculated the increase in diagnostic certainty for a consecutive number of tests. They also calculated the incremental cost-effectiveness ratio, which corresponds to the test costs divided by the increment in diagnostic certainty.
Dr Saud Suleiman and fellow researchers, of the University of New Mexico, found that IBS diagnosis could be established with a probability of more than 80% relying only on relatively inexpensive and noninvasive tests.
Flexible sigmoidoscopy and colonoscopy constituted the most costly portion of any workup for IBS, which amounted to 50-75% of the overall costs.
Analysis outcome remained largely unaffected within reasonable ranges of the sensitivity and specificity of various tests.
|Flexible sigmoidoscopy and colonoscopy accounted for 50-70% of overall IBS workup costs.|
|Archives of Internal Medicine|
"Due to their high incremental cost-effectiveness ratio, endoscopic procedures should not be used at the beginning of the diagnostic workup," commented Dr Suleiman.
"Despite their high cost, flexible sigmoidoscopy and colonoscopy should be used when a serious organic disease is reasonably likely and needs to be ruled out," it was concluded.