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Gastroenterology Research and Practice
Volume 2017 (2017), Article ID 2453254, 10 pages
https://doi.org/10.1155/2017/2453254
Research Article

Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis

1Department of Internal Medicine, St. Luke’s International Hospital, Chuo-Ku, Japan
2Center for Clinical Epidemiology, St. Luke’s International University, Chuo-Ku, Japan
3Ohta Nishinouchi Hospital, Koriyama, Japan

Correspondence should be addressed to Fumio Omata; moc.duolci@fatamo

Received 10 November 2016; Revised 6 January 2017; Accepted 11 January 2017; Published 23 February 2017

Academic Editor: Tatsuya Toyokawa

Copyright © 2017 Fumio Omata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. There are several diagnostic methods for Helicobacter pylori (H. pylori) infection. A cost-effective analysis is needed to decide on the optimal diagnostic method. The aim of this study was to determine a cost-effective diagnostic method in patients with atrophic gastritis (AG). Methods. A decision-analysis model including seven diagnostic methods was constructed for patients with AG diagnosed by esophagogastroduodenoscopy. Expected values of cost and effectiveness were calculated for each test. Results. If the prevalence of H. pylori in the patients with AG is 85% and CAM-resistant H. pylori is 30%, histology, stool H. pylori antigen (SHPAg), bacterial culture (BC), and urine H. pylori antibody (UHPAb) were dominated by serum H. pylori IgG antibody (SHPAb), rapid urease test (RUT), and urea breath test (UBT). Among three undominated methods, the incremental cost-effective ratios (ICER) of RUT versus SHPAb and UBT versus RUT were $214 and $1914, respectively. If the prevalence of CAM-sensitive H. pylori was less than 55%, BC was not dominated, but its H. pylori eradication success rate was 0.86. Conclusions. RUT was the most cost-effective at the current prevalence of CAM-resistant H. pylori. BC could not be selected due to its poor effectiveness even if CAM-resistant H. pylori was more than 45%.