2026-04-17T05:25:02Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/120312024-10-31T15:17:56Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Pizzo, Elena
author
SAYGIN AVŞAR, TUBA
author
Gonzalez-Abraldes, Juan
author
Tsochatzis, Emmanuel
author
Genesca, Joan
2024-10-31T15:17:56Z
2024-10-31T15:17:56Z
2024-10-08T06:09:01Z2024-10-08T06:09:01Z2024-10
http://hdl.handle.net/11351/12031
Economic Evaluation; Platelets; Portal HypertensionEvaluación económica; Plaquetas; Hipertensión portalAvaluació Econòmica; plaquetes; Hipertensió portalBackground & 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”).
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess
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
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion