在社区中具有成本效益的巴雷特食道鉴定:对查的第一步
Tomonori Aoki1, David I Watson1,2, Norma B Bulamu1
1Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Journal of gastroenterology and hepatology
|October 10, 2024
概括
开发有效的巴雷特食道 (BE) 查包括在社区中识别个体. 将加权风险分层与像Cytosponge-TFF3这样的不那么侵入性设备相结合,为BE检测提供了一个具有成本效益的方法.
科学领域:
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 巴雷特食道查需要有效的社区识别策略.
- 目前的方法包括内镜,非内镜装置和风险分层模型.
- 评估不同BE识别策略的成本效益至关重要.
研究的目的:
- 评估各种策略的成本效益,以在社区中识别巴雷特食道 (BE) 患者.
- 通过使用不同的选工具和组合,比较每个BE案例的成本.
主要方法:
- 模拟了两个假设的队列,在50岁以上的个人中,BE患病率为1.9%和6.8%.
- 评估了四种查工具:非加权风险分层,加权算法风险分层,细胞-TFF3和内镜.
- 利用决策分析模型,根据工具组合对六种选策略进行比较.
主要成果:
- 权重风险分层 + 细胞海绵-TFF3 + 内镜策略显示,在两种流行率中,每例BE病例的成本最低.
- 这种综合策略在1.9%的BE流行率下是最具成本效益的.
- 对于6.8%的BE患病率,细胞海绵-TFF3+内镜策略成为最具成本效益的策略.
结论:
- 综合加权风险分层和像Cytosponge-TFF3这样的更少侵入性的设备可以提高成本效益的BE查.
- 最佳的查策略受到少侵入性设备的成本和社区的BE流行程度的影响.
- 进一步研究具有成本效益的社区 BE 检测是有必要的.
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