优化对非典型症状的胃食道逆流的评估:成本效益和成本最小化分析
Eric D Shah1, Rena Yadlapati2, Walter W Chan3
1Michigan Medicine, Ann Arbor, Michigan.
优化胃食道逆流性疾病 (GERD) 对咳和吐等非典型症状的评估是具有成本效益的. 通过个性化治疗策略,有针对性的诊断改善了患者的治疗结果,并降低了医疗保健成本.
科学领域:
- 胃肠病学 胃肠病学
- 卫生经济学 卫生经济学
- 诊断战略优化 诊断战略优化
背景情况:
- 许多患有喉喉症状 (LPS),慢性咳或吐的患者被转诊进行胃食道逆流症 (GERD) 评估.
- 目前用于非典型GERD症状的诊断和管理方法可能不具有成本效益.
研究的目的:
- 优化一种具有成本效益的方法来评估表现为非典型GERD症状的患者.
- 从患者和保险公司的角度来比较不同的诊断策略.
主要方法:
- 开发了一个决策分析模型来比较常规护理 (实证质子抑制剂和内镜) 与综合性一次性诊断 (内镜和门诊逆流检测).
- 该模型在1年的时间范围内评估了成本效益,使用100,000美元/获得的QALY的支付意愿值.
- 从患者和保险公司的角度对患有LPS,吐和慢性咳的患者进行分析.
主要成果:
- 对于LPS,预先测试 (pH/阻抗,无线pH监测) 是具有成本效益的,为患者和保险公司节省资金,并改善质量调整寿命年 (QALY).
- 对于吐,前期测试确定了胃上吐,从而节省了成本,并通过腹膜呼吸疗法改善了QALY.
- 对于咳占主导地位的LPS,全面测试以排除GERD对保险公司来说是具有成本效益的,建议为患者做出特定决策.
结论:
- 基于主导症状的表型诊断和治疗方法优化了非典型GERD的评估.
- 这些发现与最近的共识建议 (里昂2.0,圣地亚哥) 一致,倡导不同的治疗途径.
- 个性化诊断策略可以提高管理与GERD相关症状的成本效益.
更多相关视频
08:25Construction of a Wireless-Enabled Endoscopically Implantable Sensor for pH Monitoring with Zero-Bias Schottky Diode-based Receiver
Published on: August 27, 2021
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
相关概念视频
Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
Assessment of the Gastrointestinal System I: Subjective Data
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...
Gastroesophageal Reflux Disease I: Meaning and Pathophysiology
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
