2026-04-13T14:19:20Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/120312024-10-31T15:17:56Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Pizzo, Elena author SAYGIN AVŞAR, TUBA author Gonzalez-Abraldes, Juan author Tsochatzis, Emmanuel author Genesca, Joan author 2024-10-08T06:09:01Z 2024-10-08T06:09:01Z 2024-10 Economic Evaluation; Platelets; Portal Hypertension Evaluación económica; Plaquetas; Hipertensión portal Avaluació Econòmica; plaquetes; Hipertensió portal Background & Aims Although upper gastrointestinal endoscopy (EGD) remains the gold standard for detecting varices in cirrhosis, the Baveno VI criteria proposed a combination of transient elastography and platelet count that could rule out high-risk varices, therefore sparing the need for an endoscopy, with significant potential cost savings. We performed a cost-effectiveness analysis of the Baveno VI criteria compared with EGD in the diagnosis of high-risk varices in cirrhosis. Methods We built an analytical decision model to estimate the cost and benefits of using the Baveno VI criteria compared with EGD in patients with Child-Pugh A cirrhosis. The analysis was performed from the UK National Health Service perspective, over 1, 5, and 20 years. A Markov model was populated with data from published evidence. Outcomes were measured in terms of quality-adjusted life years (QALYs) and avoided deaths. The analyses were repeated for Canada and Spain, using relevant cost inputs. Results The Baveno VI criteria were cost effective compared with endoscopy in all analyses. For 1000 patients, they produced 0.16 additional QALYs at an incremental cost of £326 ($443.41) over 5 years, resulting in an incremental cost of £2081 ($2830) per additional QALY gained. The incremental net monetary benefit of Baveno VI compared with EGD was £2808 ($3819) over 5 years per patient. Baveno VI criteria also were cost effective in Canada and Spain. Deterministic and probabilistic sensitivity analysis supported these findings. Conclusions The findings demonstrate that the Baveno VI criteria are cost effective, suggesting that they should be considered for widespread implementation on the basis of safety, appropriateness, and economic grounds. Elena Pizzo and Tuba Saygın Avşar were supported by the National Institute for Health and Care Research Applied Research Collaboration North Thames. Joan Genesca was supported in part by the Instituto de Salud Carlos III and cofunded by the European Union (ERDF/ESF, “Investing in your future”). http://hdl.handle.net/11351/12031 Esòfag - Malalties - Diagnòstic Cost-eficàcia Cirrosi hepàtica Plaquetes sanguínies DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Esophageal Diseases::Esophageal and Gastric Varices Other subheadings::Other subheadings::/diagnosis DISEASES::Digestive System Diseases::Liver Diseases::Liver Cirrhosis HEALTH CARE::Health Care Economics and Organizations::Economics::Costs and Cost Analysis::Cost-Benefit Analysis ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Cell Count::Blood Cell Count::Platelet Count ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades del esófago::varices esofágicas y gástricas Otros calificadores::Otros calificadores::/diagnóstico ENFERMEDADES::enfermedades del sistema digestivo::enfermedades hepáticas::cirrosis hepática ATENCIÓN DE SALUD::economía y organizaciones para la atención de la salud::economía::costes y análisis de costes::análisis coste-beneficio TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::técnicas de laboratorio clínico::técnicas citológicas::recuento de células::recuento de células sanguíneas::recuento de plaquetas Cost-Effectiveness of the Baveno VI Criteria Compared With Endoscopy for High-Risk Varices in Patients With Child-Pugh A Cirrhosis