Levy Bar, Fliss Isakov Naomi, Ziv-Baran Tomer, Leshno Moshe, Maharshak Nitsan, Werner Lael
School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Tel Aviv, Israel.
MDM Policy Pract. 2024 Jun 13;9(1):23814683241254809. doi: 10.1177/23814683241254809. eCollection 2024 Jan-Jun.
Fecal microbial transplantation (FMT) is the delivery of fecal microbiome, isolated from healthy donors, into a patient's gastrointestinal tract. FMT is a safe and efficient treatment for recurrent infection. Donors undergo strict screening to avoid disease transmission. This consists of several blood and stool tests, which are performed in a multistage, costly process. We performed a cost-minimizing analysis to find the optimal order in which the tests should be performed. An algorithm to optimize the order of tests in terms of cost was defined. Performance analysis for disqualifying a potential healthy donor was carried out on data sets based on either the published literature or our real-life data. For both data sets, we calculated the total cost to qualify a single donor according to the optimal order of tests, suggested by the algorithm. Applying the algorithm to the published literature revealed potential savings of 94.2% of the cost of screening a potential donor and 7.05% of the cost to qualify a single donor. In our cohort of 87 volunteers, 53 were not eligible for donation. Of 34 potential donors, 10 were disqualified due to abnormal lab tests. Applying our algorithm to optimize the order of tests, the average cost for screening a potential donor resulted in potential savings of 49.9% and a 21.3% savings in the cost to qualify a single donor. Improving the order and timing of the screening tests of potential FMT stool donors can decrease the costs by about 50% per subject.
What is known:Fecal microbial transplantation (FMT) is the transfer of microbiome from healthy donors to patients.Fecal donors undergo multiple strict screening tests to exclude any transmissible disease.Screening tests of potential fecal donors is expensive and time consuming.FMT is the most efficient treatment for recurrent infection.What is new here:An algorithm to optimize the order of donors' screening tests in terms of cost was defined.Optimizing the order tests can save nearly 50% in costs of screening a potential donor.
粪便微生物群移植（FMT）是将从健康供体分离出的粪便微生物群输送到患者的胃肠道。FMT是治疗复发性感染的一种安全有效的方法。供体要接受严格筛查以避免疾病传播。这包括多项血液和粪便检测，检测过程分多阶段进行，成本高昂。我们进行了成本最小化分析，以找出检测应按的最优顺序。定义了一种根据成本优化检测顺序的算法。基于已发表文献或我们的实际数据，对数据集进行了潜在健康供体不合格的性能分析。对于这两个数据集，我们根据算法建议的最优检测顺序，计算了使单个供体合格的总成本。将该算法应用于已发表文献显示，筛选潜在供体的成本可节省94.2%，使单个供体合格的成本可节省7.05%。在我们的87名志愿者队列中，53人不符合捐赠条件。在34名潜在供体中，10人因实验室检测异常而被取消资格。应用我们的算法优化检测顺序，筛选潜在供体的平均成本可节省49.9%，使单个供体合格的成本可节省21.3%。改善潜在FMT粪便供体筛查检测的顺序和时间，可使每个受试者的成本降低约50%。
已知内容：粪便微生物群移植（FMT）是将微生物群从健康供体转移到患者。粪便供体要接受多项严格筛查检测以排除任何可传播疾病。潜在粪便供体的筛查检测成本高昂且耗时。FMT是治疗复发性感染最有效的方法。新内容：定义了一种根据成本优化供体筛查检测顺序的算法。优化检测顺序可使筛选潜在供体的成本节省近50%。
