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Clin Gastroenterol H:多普勒探头在非静脉曲张上消化道出血治疗中成本更低且更有效

2019-02-18 xing.T 网络

由此可见,在成本效益分析中,研究人员发现DPE相比于TEA治疗非静脉曲张性上消化道出血患者高风险病变在经济效益上更占优势;DPE成本更低,效率更高。

消化道出血是常见的急症,再出血与死亡风险增加有关。为获得最佳结果,需要对高风险病变进行适当评估并进行适当的内镜止血。内窥镜多普勒探针检查(DPE)允许更全面地评估出血,更好地评估内窥镜止血的需要,并确定其完整性。近日,消化病领域权威杂志Clinical Gastroenterology and Hepatology发表了一篇研究文章,研究人员的目的是评估高风险的非静脉曲张性上消化道出血患者,与传统内镜视觉评估(TEA)相比,使用DPE是否在成本和有效性方面具有额外的优势。

研究人员绘制了一个决策树,代表DPE和TEA方法之间的选择,用于接受指数内镜检查治疗活动性非静脉曲张性上消化道出血的患者。从随机对照试验数据中检索临床概率。费用采用2017的美元汇率来衡量。采用第三方付款人的观点,研究人员进行了确定性和概率敏感性分析。所采用的时间范围是窥镜检查后30天。

研究人员发现DPE比TEA更占优势,因为DPE更有效(92.6%的患者避免再出血,而TEA为78.6%)且更便宜(TEA为8502美元 vs. 9104美元)。当在跨越其各自基线值的30%的范围内变化时,DPE相对于TEA的经济优势对于模型的所有假设的灵敏度分析是稳健的。

由此可见,在成本效益分析中,研究人员发现DPE相比于TEA治疗非静脉曲张性上消化道出血患者高风险病变在经济效益上更占优势;DPE成本更低,效率更高。 

原始出处:

Alan N. Barkun,et al.Use of Doppler Probe in Non-Variceal Upper-Gastrointestinal Bleeding is Less Costly and More Effective Than Standard of Care. Clinical gastroenterology and hepatology.2019.https://www.cghjournal.org/article/S1542-3565(19)30179-X/fulltext

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    2021-05-15 ms5000000357833599

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    2019-04-08 许安
  5. [GetPortalCommentsPageByObjectIdResponse(id=965873, encodeId=31599658e315, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e85463857, createdName=ms5000000357833599, createdTime=Sat May 15 17:41:15 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711824, encodeId=1edb1e118244a, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Dec 01 17:34:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064623, encodeId=a969206462304, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Jan 19 11:34:00 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072454, encodeId=0de520e245479, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon Apr 08 16:34:00 CST 2019, time=2019-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697854, encodeId=4910169e8547b, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Tue Jul 30 07:34:00 CST 2019, time=2019-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723071, encodeId=eccf1e2307198, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Tue May 21 14:34:00 CST 2019, time=2019-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446640, encodeId=580514466405f, content=<a href='/topic/show?id=df3243284bb' target=_blank style='color:#2F92EE;'>#多普勒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43284, encryptionId=df3243284bb, topicName=多普勒)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=ic4miaOAE2ia8de4wOCCZKVng&s=100&t=1577421237, createdBy=e1965265549, createdName=shenxlcyp, createdTime=Wed Feb 20 07:34:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464605, encodeId=10681464605d3, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Wed Feb 20 07:34:00 CST 2019, time=2019-02-20, status=1, ipAttribution=)]
    2019-07-30 fusion
  6. [GetPortalCommentsPageByObjectIdResponse(id=965873, encodeId=31599658e315, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e85463857, createdName=ms5000000357833599, createdTime=Sat May 15 17:41:15 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711824, encodeId=1edb1e118244a, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Dec 01 17:34:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064623, encodeId=a969206462304, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Jan 19 11:34:00 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072454, encodeId=0de520e245479, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon Apr 08 16:34:00 CST 2019, time=2019-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697854, encodeId=4910169e8547b, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Tue Jul 30 07:34:00 CST 2019, time=2019-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723071, encodeId=eccf1e2307198, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Tue May 21 14:34:00 CST 2019, time=2019-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446640, encodeId=580514466405f, content=<a href='/topic/show?id=df3243284bb' target=_blank style='color:#2F92EE;'>#多普勒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43284, encryptionId=df3243284bb, topicName=多普勒)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=ic4miaOAE2ia8de4wOCCZKVng&s=100&t=1577421237, createdBy=e1965265549, createdName=shenxlcyp, createdTime=Wed Feb 20 07:34:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464605, encodeId=10681464605d3, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Wed Feb 20 07:34:00 CST 2019, time=2019-02-20, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=965873, encodeId=31599658e315, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e85463857, createdName=ms5000000357833599, createdTime=Sat May 15 17:41:15 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711824, encodeId=1edb1e118244a, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Dec 01 17:34:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064623, encodeId=a969206462304, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Jan 19 11:34:00 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072454, encodeId=0de520e245479, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon Apr 08 16:34:00 CST 2019, time=2019-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697854, encodeId=4910169e8547b, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Tue Jul 30 07:34:00 CST 2019, time=2019-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723071, encodeId=eccf1e2307198, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Tue May 21 14:34:00 CST 2019, time=2019-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446640, encodeId=580514466405f, content=<a href='/topic/show?id=df3243284bb' target=_blank style='color:#2F92EE;'>#多普勒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43284, encryptionId=df3243284bb, topicName=多普勒)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=ic4miaOAE2ia8de4wOCCZKVng&s=100&t=1577421237, createdBy=e1965265549, createdName=shenxlcyp, createdTime=Wed Feb 20 07:34:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464605, encodeId=10681464605d3, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Wed Feb 20 07:34:00 CST 2019, time=2019-02-20, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=965873, encodeId=31599658e315, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77e85463857, createdName=ms5000000357833599, createdTime=Sat May 15 17:41:15 CST 2021, time=2021-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711824, encodeId=1edb1e118244a, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Dec 01 17:34:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064623, encodeId=a969206462304, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sun Jan 19 11:34:00 CST 2020, time=2020-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072454, encodeId=0de520e245479, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Mon Apr 08 16:34:00 CST 2019, time=2019-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697854, encodeId=4910169e8547b, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Tue Jul 30 07:34:00 CST 2019, time=2019-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723071, encodeId=eccf1e2307198, content=<a href='/topic/show?id=0cc01998259' target=_blank style='color:#2F92EE;'>#上消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19982, encryptionId=0cc01998259, topicName=上消化道)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b81833366357, createdName=zchen, createdTime=Tue May 21 14:34:00 CST 2019, time=2019-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446640, encodeId=580514466405f, content=<a href='/topic/show?id=df3243284bb' target=_blank style='color:#2F92EE;'>#多普勒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43284, encryptionId=df3243284bb, topicName=多普勒)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/g?b=oidb&k=ic4miaOAE2ia8de4wOCCZKVng&s=100&t=1577421237, createdBy=e1965265549, createdName=shenxlcyp, createdTime=Wed Feb 20 07:34:00 CST 2019, time=2019-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464605, encodeId=10681464605d3, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Wed Feb 20 07:34:00 CST 2019, time=2019-02-20, status=1, ipAttribution=)]
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