Efficiency of Diagnostic Testing for Helicobacter pylori Infections-A Systematic Review

Area of Science:

• Health Economics
• Infectious Diseases
• Microbiology

Background:

• High-dose combined antibiotics are the standard treatment for Helicobacter pylori infections.
• Economic evaluations of diagnostic testing for H. pylori are reviewed.
• The incorporation of antimicrobial resistance (AMR) into economic models is examined.

Purpose of the Study:

• To systematically review economic evaluation studies of diagnostic testing for H. pylori infections.
• To identify key characteristics of these studies.
• To understand how AMR is addressed in economic evaluations.

Main Methods:

• A systematic review was conducted comparing costs and clinical effectiveness of H. pylori diagnostic strategies.
• Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.
• Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist items were extracted.

Main Results:

• Thirteen high-quality studies (per CHEERS) were identified.
• Six studies focused on H. pylori diagnostics for dyspepsia; four for duodenal ulcers.
• Testing was the most cost-effective strategy in eight studies; four studies considered AMR.

Conclusions:

• Diagnostic testing is more cost-effective than empirical treatment, barring high prevalence or stratified comorbidities.
• The inclusion of AMR in economic models can influence the efficiency of diagnostic strategies.
• Further research may be needed to fully integrate AMR into H. pylori economic evaluations.