Decision-Utility Analysis of Empiric Treatment Versus Test and Treat Strategies for Helicobacter pylori in Patients With Duodenal Ulcer.

Autor: Alsahafi M; Division of Gastroenterology, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: maaalsahafi1@kau.edu.sa., Mosli M; Division of Gastroenterology, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Alkhowaiter S; Division of Gastroenterology, Department of Medicine, King Saud University, Riyadh, Saudi Arabia., Donnellan F; Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk: angličtina
Zdroj: Value in health regional issues [Value Health Reg Issues] 2024 Jan; Vol. 39, pp. 1-5. Date of Electronic Publication: 2023 Nov 14.
DOI: 10.1016/j.vhri.2023.08.007
Abstrakt: Objectives: The optimal strategy of Helicobacter pylori eradication in patients with duodenal ulcer is unclear. In this study, we aimed to compare the utility and the ulcer recurrence rate using the empiric treatment versus the test and treat strategies in patients with uncomplicated duodenal ulcer.
Methods: A decision-utility analysis was performed using a decision tree. The empiric treatment strategy was compared with the test and treat strategy. The probabilities of recurrent ulcers were determined and utilities of the 2 strategies were compared using the quality-adjusted life-year (QALY). Sensitivity analysis was performed to evaluate for model robustness.
Results: The probability of recurrent ulcer with the empiric strategy was 10.5%. The probabilities of recurrent ulcer with the test and treat strategy were 12.6%, 14.7%, 16.8%, and 17.9% based on 95%, 90%, 85%, and 80% sensitivity for histopathology, respectively. At the 95% estimate for the sensitivity of histopathology, the empiric strategy was associated with greater QALY compared with the test and treat strategy, 0.9875 versus 0.9853. The empiric treatment strategy was associated with greater QALY at extreme values for the estimates in our model.
Conclusions: The empiric treatment strategy is associated with 2.1% to 7.4% lower recurrence rate for a range of test sensitivity between 95% and 80%, and results in greater QALY compared with the test and treat strategy.
(Copyright © 2023 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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