胶囊内镜在疑似小肠克罗恩病中的应用：疾病诊断和治疗的经济影响。
Capsule endoscopy in suspected small bowel Crohn's disease: economic impact of disease diagnosis and treatment.
机构信息
Division of Health Policy, Department of Radiology, University of California San Diego, San Diego, CA 92103, USA.
出版信息
World J Gastroenterol. 2009 Dec 7;15(45):5685-92. doi: 10.3748/wjg.15.5685.
AIM
To model clinical and economic benefits of capsule endoscopy (CE) compared to ileo-colonoscopy and small bowel follow-through (SBFT) for evaluation of suspected Crohn's disease (CD).
METHODS
Using decision analytic modeling, total and yearly costs of diagnostic work-up for suspected CD were calculated, including procedure-related adverse events, hospitalizations, office visits, and medications. The model compared CE to SBFT following ileo-colonoscopy and secondarily compared CE to SBFT for initial evaluation.
RESULTS
Aggregate charges for newly diagnosed, medically managed patients are approximately $8295. Patients requiring aggressive medical management costs are $29,508; requiring hospitalization, $49,074. At sensitivity > 98.7% and specificity of > 86.4%, CE is less costly than SBFT.
CONCLUSION
Costs of CE for diagnostic evaluation of suspected CD is comparable to SBFT and may be used immediately following ileo-colonoscopy.
目的
建立胶囊内镜（CE）与回结肠镜和小肠通过试验（SBFT）用于疑似克罗恩病（CD）评估的临床和经济效益模型。
方法
采用决策分析模型，计算疑似 CD 患者诊断性检查的总费用和年度费用，包括与操作相关的不良事件、住院、就诊和药物治疗。模型将 CE 与回结肠镜后 SBFT 进行比较，并对初始评估时 CE 与 SBFT 进行了比较。
结果
新诊断的、接受药物治疗的患者的综合费用约为 8295 美元。需要积极药物治疗的患者费用为 29508 美元，需要住院治疗的患者费用为 49074 美元。在敏感性>98.7%和特异性>86.4%的情况下，CE 的成本低于 SBFT。
结论
CE 用于疑似 CD 的诊断性评估的成本与 SBFT 相当，并且可以在回结肠镜后立即使用。
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