Cost-effectiveness of Endoscopy in Irritable Bowel Syndrome

Suleiman, Saud; Sonnenberg, Amnon

doi:10.1001/archinte.161.3.369

Cited by 34 publications

(19 citation statements)

References 27 publications

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“…Previous studies of the economic burden of gastrointestinal (GI) disorders included only selected populations, 7,8 because total-population or representative-sample data were not readily available. Previous studies also focused exclusively on the financial implications of diagnostic measures or therapeutic interventions, 9,10 rather than analyses of the entire specialty. 10 In Korea, all citizens are automatically registered with the compulsory insurance program, the National Health Insurance (NHI) system which covers almost 100% of entire Korean population.…”

Section: Introductionmentioning

confidence: 99%

Estimating the Burden of Irritable Bowel Syndrome: Analysis of a Nationwide Korean Database

Jung¹,

Kim²,

Park³

et al. 2014

J Neurogastroenterol Motil

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Background/AimsManagement of irritable bowel syndrome (IBS) imposes a heavy economic burden. This study was to estimate the epidemiologic features of IBS and to report the IBS burden for the first time in the Korean population. MethodsA cross-sectional study was conducted using the National Health Insurance (NHI) system database, which covers the entire population of Korea. IBS was defined as diagnostic code -10 in adults with any outpatient clinic visits or hospitalization related to IBS. We excluded diseases that mimic IBS symptoms. ResultsA total of 2.42 million (58.2% female) individuals were identified as patients with IBS, yielding an age-and gender-adjusted prevalence of 5.1% in males and 6.9% in females. The prevalence of IBS increased proportionally with age, with higher medical costs in middle-aged patients. Outpatient clinics were visited by 98.6% of IBS patients, and 1.9% were treated upon admission. Of these patients, 87.6% were given a prescription. Co-morbidities that commonly accompanied IBS included upper gastrointestinal (36.1%), respiratory (12.3%), musculoskeletal (8.0%) disease, somatoform (4.3%) and depression/anxiety disorders (3.1%). The NHI costs of IBS, which include the NHI covered cost and beneficiary copayment charges, were estimated to be 155 million USD, which accounts for 0.46% of the total NHI costs for the entire Korean population. ConclusionsAccording to the Korean national claims database, about 6% of the Korean population seeks medical care for IBS at least once per year. This high prevalence places a large economic burden on the Korean healthcare system, accounting for 0.46% of overall national medical expenditure.

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Section: Introductionmentioning

confidence: 99%

Estimating the Burden of Irritable Bowel Syndrome: Analysis of a Nationwide Korean Database

Jung¹,

Kim²,

Park³

et al. 2014

J Neurogastroenterol Motil

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“…Organik nedenleri d›fl-lamak amac›yla tam kan say›m›, eritrosit sedimantasyon h›z›, temel biyokimyasal parametrelerin bak›lmas› gibi temel testler önerilmekle birlikte alarm semptomu olmayan bireylerde kolonoskopi ve di¤er görüntüleme yöntemleri gibi ileri incelemeler önerilmemektedir. Çünkü endoskopik ifllemlerin maliyet etkinli¤i üzerine yap›lm›fl birçok çal›flmada bu tetkiklerin ‹BS'nin sebep oldu¤u yüksek maliyeti daha da yükseltti¤i belirtilmifltir (4). Fakat birkaç çal›flmada ‹BS tan›s› düflünülen olgularda kolonoskopi'nin önemli bir tan› arac› oldu¤u ileri sürülmektedir.…”

Section: G‹r‹fiunclassified

“…Maliyet etkinli¤i yan›nda overlap sendromlar› içerisinde yer alabilmesi ‹BS'nin önemli özelliklerinden biridir. Buna en iyi örnek ise mikroskopik kolit ile ‹BS'nin ça-k›flmas›d›r (4,5). Diyare dominant ‹BS'li olgularda bulgular (klinik, laboratuvar ve kolonoskopik) benzerlik göstermekte-dir (12,13) ve bu nedenle bu tip olgularda kolonoskopi yap›-l›p kolondan biyopsi almakta ve patologlar› da materyali incelerken mikroskopik kolit yönünden uyarmakta fayda vard›r.…”

Section: Tartifimaunclassified

İrritabl barsak sendromu ve kolonoskopi

Kasap¹,

Semiz²,

Gerçeker³

et al. 2015

Endoskopi Gastrointestinal

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Girifl ve Amaç: ‹rritabl barsak sendromu tan›s› semptom tabanl›d›r.Tan›da kolonoskopinin yeri tart›flmal›d›r. Çal›flmada amac›m›z kolonoskopi yap›lan irritabl barsak sendromlu olgular›n kolonoskopik bulgular›n› kontrol grubu ile retrospektif olarak karfl›laflt›r›p irritabl barsak sendromlu olgularda kolonoskopinin tan›da yerinin olup olmad›¤›n› de¤erlendirmektir. Gereç ve Yön-tem: Celal Bayar Üniversitesi T›p Fakültesi Gastroenteroloji Klini¤imizde 2006 ile 2010 y›llar› aras›nda yap›lan 2485 kolonoskopi verileri retrospektif olarak tarand› ve Roma II tan› kriterleri ile ‹BS tan›s› konulan 210 olgu ve 166 kontrol grubunun verileri de¤erlendirildi. Bulgular: Kolonoskopik bulgular irritabl barsak sendromlu olgularda %65 kontrol grubunda ise %74 oran›nda normal idi. Polip irritabl barsak sendromlu olgular›n %17.1'inde kontrol grubunun ise %7.8'inde rastlanm›flt›r ve irritabl barsak sendromlu olgularda polip rastlanma oran› kontrol grubuna göre anlaml› olarak yüksek bulunmufltur. Sonuç: Her ne kadar istatistiksel olarak kolonoskopik bulgular›n normal olma olas›l›¤› patolojik olma olas›l›¤›ndan anlaml› olarak yüksek olsa da irritabl barsak sendromu düflünülen hastalarda kolonoskopi yap›lmas›n›n gereklili¤inin bir kez daha gözden geçirilmesi gerekti¤ini düflünmekteyiz. Anahtar kelimeler: ‹rritabl barsak sendromu, kolonoskopi, organik lezyonlarBackground and Aims: The diagnosis of irritable bowel syndrome is symptom-based and the use of colonoscopy for diagnosis is not clearly defined. The aim of this study was to compare the colonoscopic findings in patients with irritable bowel syndrome and a control group and to evaluate the diagnosis by colonoscopy in patients with irritable bowel syndrome. Materials and Methods: The study included 210 irritable bowel syndrome patients and 166 controls identified retrospectively from among 2485 patients who underwent colonoscopy in Celal Bayar University Faculty of Medicine, Gastroenterology Department, between 2006 and 2010. Results: Colonoscopy findings were normal in 65% in the irritable bowel syndrome group and in 74% in the control group. The frequency of polyps was found to be more common in patients with irritable bowel syndrome (17.1%) than in the control group (7.4%). Conclusions: Although the statistical probability of normal colonoscopic findings is greater than of pathologic findings in irritable bowel syndrome patients, we believe the requirement of performing a colonoscopy should be revised once again.

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“…Because of the high incremental cost-effectiveness ratio (the increment in test costs divided by the increment in diagnostic certainty) of these tests, the authors recommended against their use at the beginning of a diagnostic evaluation; rather, they advised the use of these tests "when a serious organic disease is reasonably likely and needs to be ruled out." [12]. However, experienced clinicians find that completion of diagnostic testing lays the groundwork for explanation and reassurance; spreading tests out over time can interfere with this critical part of management.…”

Section: Practice Guidelinesmentioning

confidence: 99%

New developments in the diagnosis and treatment of irritable bowel syndrome

Longstreth

Drossman²

2002

Curr Gastroenterol Rep

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Irritable bowel syndrome (IBS) is a common disorder with major health status and economic effects. Symptom criteria are of paramount importance in diagnosis, but differences among the Manning, Rome I, and Rome II criteria may lead to variable identification of people with the disorder. Practice guidelines are based on evidence and, to a greater degree, on consensus; therefore, experts vary on the specifics of ordering particular diagnostic tests. There is an overlap of IBS symptoms with those of celiac sprue, and selected patients should be tested for the latter disease. Symptom confusion with biliary pain and overlap with chronic pelvic pain could contribute to the predisposition of IBS patients to undergo cholecystectomy and hysterectomy. Development and documentation of effective therapy has been difficult, but depending on the selection of subgroups, there is evidence for usefulness of smooth muscle relaxants, loperamide, and antidepressants. Various forms of psychological therapy and new serotonin-modulating agents seem especially promising. The placebo effect of the physician-patient relationship has important therapeutic benefit.

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Cost-effectiveness of Endoscopy in Irritable Bowel Syndrome

Cited by 34 publications

References 27 publications

Estimating the Burden of Irritable Bowel Syndrome: Analysis of a Nationwide Korean Database

Estimating the Burden of Irritable Bowel Syndrome: Analysis of a Nationwide Korean Database

İrritabl barsak sendromu ve kolonoskopi

New developments in the diagnosis and treatment of irritable bowel syndrome

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