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Evaluation of the Cost-Utility of the York Faecal Calprotectin Care Pathway.

Published on Apr 5, 2020in Expert Review of Pharmacoeconomics & Outcomes Research1.828
· DOI :10.1080/14737167.2020.1751613
Hayden Holmes2
Estimated H-index: 2
,
Jessica McMaster1
Estimated H-index: 1
+ 2 AuthorsJames Turvill6
Estimated H-index: 6
(York Hospital)
Abstract
Background: Lower gastrointestinal symptoms are common in the general population and it can be difficult to discriminate between inflammatory bowel disease (IBS) and irritable bowel syndrome (IBD) due to overlap of symptoms. The York Faecal Calprotectin Care Pathway (YFCCP) was introduced in 2016 as an alternative to the NICE faecal calprotectin pathway (DG11). This analysis uses the prospective data from the first 1005 patients in the YFCCP. Previous analysis demonstrated the YFCCP may be cost-saving when compared with the DG11 pathway. This analysis examined the short-term health-related quality of life (HRQoL) impact for patients in the YFCCP for IBD and IBS.Methods: A decision tree model was used to estimate the proportion of people presenting with lower gastrointestinal symptoms that were correctly or falsely diagnosed with IBS and IBD. Time to diagnosis data was estimated and HRQoL data was estimated from published sources. Costs and QALYs were calculated for the YFCCP and each comparator.Results: The YFCCP was cost-effective at a pound20,000 threshold when compared with the current NICE recommended pathways and was cost-saving with a QALY gain (dominant)in four of the five comparators. Conclusions: The YFCCP demonstrated a QALY benefit when compared with all alternative pathways.
  • References (14)
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References14
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#1James Turvill (York Hospital)H-Index: 6
#2Daniel TurnockH-Index: 5
Last. Stacey MarriottH-Index: 1
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Objective To evaluate the sensitivity and specificity of the York Faecal Calprotectin Care Pathway (YFCCP) and undertake a health economics analysis. The YFCCP has been introduced in support of the National Institute for Health and Care Excellence (NICE) guidance DG11. It is designed to improve the sensitivity and specificity of faecal calprotectin (FC) in discriminating the irritable bowel syndrome from inflammatory bowel disease in primary care. Design To prospectively evaluate the clinical ou...
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#2Dingfeng Jiang (AbbVie)H-Index: 1
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BACKGROUND: The impact of diagnostic delay in inflammatory bowel disease, including Crohn's disease (CD) and ulcerative colitis (UC), on disease course remains uncertain. This study examines factors that may influence time to diagnosis and disease outcomes in a U.S. patient cohort. METHODS: We retrospectively collected data on patient characteristics, time to diagnosis, disease phenotype, and complications in 177 patients with inflammatory bowel disease (110 CD and 67 UC) diagnosed at our instit...
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Irritable bowel syndrome (IBS), a common gastrointestinal disorder involving the gut-brain axis, and inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder, are both increasing in incidence and prevalence in Asia. Both have significant overlap in terms of symptoms, pathophysiology, and treatment, suggesting the possibility of IBS and IBD being a single disease entity albeit at opposite ends of the spectrum. We examined the similarities and differences in IBS and IBD, and off...
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#1M Mendall (Croydon University Hospital)H-Index: 6
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Background Faecal calprotectin (FC) is one of the most widely used non-invasive tests for the diagnosis and assessment of Crohn’s disease (CD) activity. Despite this, factors other than disease activity which affect levels have not been extensively reviewed. This is of importance when using FC in the diagnostic setting but also may be of utility in studying the aetiology of disease.
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Diagnostic Delay in Crohn's Disease Is Associated With a Complicated Disease Course and Increased Operation Rate
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Background & Aims Depression and psychosocial stress are believed to contribute to the pathogenesis of Crohn's disease (CD) and ulcerative colitis (UC). Although many mechanisms have been proposed to link these disorders, few prospective studies have examined the relationship between depressed mood and incidence of CD or UC. Methods We analyzed data from 152,461 women (aged 29–72 years) enrolled since 1992–1993 in the Nurses' Health Study cohorts I and II. Self-reported depressive symptoms were ...
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