成人乳糜泻无活检诊断的成本效益和环境影响

IF 2.4 Q3 GASTROENTEROLOGY & HEPATOLOGY
Mohamed G Shiha, Nicoletta Nandi, Andrew J Hutchinson, Suneil A Raju, Foong Way David Tai, Luca Elli, Hugo A Penny, David Surendran Sanders
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引用次数: 0

摘要

目的近期有证据表明,成人IgA组织转谷氨酰胺酶水平≥10倍正常值上限可准确诊断乳糜泻,而无需进行内镜检查和活检。我们的目的是评估在临床实践中实施无活检方法诊断乳糜泻的成本效益和环境影响。基于全国平均单位成本和国家统计局的数据,我们计算了诊断乳糜泻的常规血清学活检方法和无活检方法的总直接和间接成本。根据内窥镜检查产生的温室气体排放量,我们进一步估计了避免内窥镜检查对环境的影响。结果在英国,每年约有3000例疑似乳糜泻的内窥镜检查可以避免。采用无活检方法诊断成人乳糜泻,每年可为英国国民健康服务节省250多万英镑的直接和间接成本,每年可减少内窥镜检查产生的碳足迹87吨二氧化碳,相当于开车222,875英里产生的温室气体排放量,相当于为1000多万部智能手机充电产生的碳排放量,相当于1438棵树生长10年所吸收的碳排放量。结论:这种非侵入性绿色方法的实施可能是英国胃肠病学会和其他国际内窥镜学会倡导的可持续内窥镜实践“减少”战略的重要第一步。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-benefits and environmental impact of the no-biopsy approach for the diagnosis of coeliac disease in adults
Objective Recent evidence suggests that adult patients with IgA tissue transglutaminase levels of ≥10× the upper limit of normal could be accurately diagnosed with coeliac disease without undergoing endoscopy and biopsy. We aimed to evaluate the cost-benefits and the environmental impact of implementing the no-biopsy approach for diagnosing coeliac disease in clinical practice. Design We calculated the overall direct and indirect costs of the conventional serology-biopsy approach and the no-biopsy approach for the diagnosis of coeliac disease based on the national average unit costs and the Office of National Statistics data. We further estimated the environmental impact of avoiding endoscopy based on the estimated greenhouse gas emissions from endoscopy. Results Approximately 3000 endoscopies for suspected coeliac disease could be avoided each year in the UK. Implementing the no-biopsy approach for the diagnosis of coeliac disease in adults could save the National Health Service over £2.5 million in direct and indirect costs per annum and reduce endoscopy carbon footprint by 87 tonnes of CO 2 per year, equivalent to greenhouse gas emissions from driving 222 875 miles, carbon emissions from charging over 10 million smartphones and the carbon sequestrated by 1438 trees grown for 10 years. Conclusion The implementation of this non-invasive green approach could be an essential first step in the ‘Reduce’ strategy advocated by the British Society of Gastroenterology and other international endoscopy societies for sustainable endoscopy practice.
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来源期刊
Frontline Gastroenterology
Frontline Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.70
自引率
11.50%
发文量
93
期刊介绍: Frontline Gastroenterology publishes articles that accelerate adoption of innovative and best practice in the fields of gastroenterology and hepatology. Frontline Gastroenterology is especially interested in articles on multidisciplinary research and care, focusing on both retrospective assessments of novel models of care as well as putative future directions of best practice. Specifically Frontline Gastroenterology publishes articles in the domains of clinical quality, patient experience, service provision and medical education.
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