296 Rockall and Blatchford Scores to Identify Emergency Department Patients With Suspected Upper Gastrointestinal Bleeding Who Do Not Need Endoscopic Intervention

Meltzer, Andrew C.; Burnett, Sarah; Pinchbeck, Carrie; Brown, Andrew; Choudhri, Tina; Pines, Jesse M.

doi:10.1016/j.annemergmed.2011.06.326

Cited by 3 publications

(1 citation statement)

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“…7 However, survey studies have shown that there is very poor uptake by US physicians of this rule and some limitations to its use in US settings. 10,14,31 As a result, the Blatchford score has demonstrated limited impact on clinical care. In addition, the low specificity of the Blatchford score means that most patients with suspected upper GI hemorrhage are typically still admitted.…”

Section: Discussionmentioning

confidence: 99%

The Cost-Effectiveness Analysis of Video Capsule Endoscopy Compared to Other Strategies to Manage Acute Upper Gastrointestinal Hemorrhage in the Emergency Department

Meltzer¹,

Ward²,

Gralnek³

et al. 2013

Annals of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

The Cost-Effectiveness Analysis of Video Capsule Endoscopy Compared to Other Strategies to Manage Acute Upper Gastrointestinal Hemorrhage in the Emergency Department

Meltzer¹,

Ward²,

Gralnek³

et al. 2013

Annals of Emergency Medicine

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The cost-effectiveness analysis of video capsule endoscopy compared to other strategies to manage acute upper gastrointestinal hemorrhage in the ED

Meltzer

Ward

Gralnek

et al. 2014

The American Journal of Emergency Medicine

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Study objective Acute upper gastrointestinal (GI) hemorrhage is a common presentation in hospital-based emergency departments (EDs). A novel diagnostic approach is to use video capsule endoscopy to directly visualize the upper GI tract and identify bleeding. Our objective was to evaluate and compare the relative costs and benefits of video capsule endoscopy compared to other strategies in low to moderate risk ED patients with acute upper GI hemorrhage. Methods We constructed a model using standard decision analysis software to examine the cost-effectiveness of four available strategies for a base-case patient who presents to the ED with either mild or moderate risk scenarios (by Glasgow-Blatchford Score) for requiring invasive hemostatic intervention (i.e., endoscopic, surgical, etc.) The four available diagnostic strategies were (1) direct imaging with video capsule endoscopy performed in the ED, (2) risk stratification using the Glasgow-Blatchford score, (3) nasogastric tube placement and, finally, (4) an admit-all strategy. Results In the low-risk scenario, video capsule endoscopy was preferred strategy (cost $5,691, 14.69 QALYs) and more cost effective than the remaining strategies including nasogastric tube strategy (cost $8,159, 14.69 QALYs), risk stratification strategy (cost $10,695, 14.69 QALYs) and admit-all strategy (cost $22,766, 14.68 QALYs). In the moderate risk scenario, video capsule endoscopy continued to be preferred strategy (cost $9,190, 14.56 QALYs) compared to nasogastric tube (cost $9,487, 14.58 QALYs, ICER $15,891) and more cost effective than admit-all strategy (cost, $22,584, 14.54 QALYs.) Conclusion Video capsule endoscopy may be cost-effective for low and moderate risk patients presenting to the ED with acute upper GI hemorrhage.

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Video Capsule Endoscopy in the Emergency Department: A Prospective Study of Acute Upper Gastrointestinal Hemorrhage

Meltzer

Ali

Kresiberg

et al. 2013

Annals of Emergency Medicine

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296 Rockall and Blatchford Scores to Identify Emergency Department Patients With Suspected Upper Gastrointestinal Bleeding Who Do Not Need Endoscopic Intervention

Cited by 3 publications

References 0 publications

The Cost-Effectiveness Analysis of Video Capsule Endoscopy Compared to Other Strategies to Manage Acute Upper Gastrointestinal Hemorrhage in the Emergency Department

The Cost-Effectiveness Analysis of Video Capsule Endoscopy Compared to Other Strategies to Manage Acute Upper Gastrointestinal Hemorrhage in the Emergency Department

The cost-effectiveness analysis of video capsule endoscopy compared to other strategies to manage acute upper gastrointestinal hemorrhage in the ED

Video Capsule Endoscopy in the Emergency Department: A Prospective Study of Acute Upper Gastrointestinal Hemorrhage

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