Users' Guides to the Medical Literature
Guyatt G, Rennie D, Meade MO, Cook DJ
Part G Moving from Evidence to Action
Chapter 22.1. Economic Analysis
Michael Drummond, Ron Goeree, Paul Moayyedi, Mitch Levine
Clinical Scenario
Topics Discussed:
application of economic analysis (cost-effectiveness), cost effectiveness, dyspepsia, economic analysis (cost-effectiveness), endoscopy, helicobacter pylori
Excerpt:
"You are a gastroenterologist on the staff of a large community
hospital. Your chief of medicine knows your interest in evidence-based medicine, and she asks you
to help her solve a problem. There is considerable pressure on the
endoscopy service to provide more colonoscopy screening to reduce
colorectal cancer mortality, but no funds are available to increase
endoscopy facilities. Approximately 50% of the workload
is devoted to upper gastrointestinal endoscopy for patients with
dyspepsia. One possibility is to reduce upper gastrointestinal endoscopy
demand by providing a Helicobacter pylori test
and treat service as the preferential management strategy for patients
younger than 55 years with dyspepsia without alarm symptoms.
This strategy involves giving patients a noninvasive test for H
pylori (eg, a serology test or urea breath test), treating
patients with positive results with antibiotic therapy, and reassuring
patients with negative results that they are unlikely to have peptic
ulcer disease...."
Log in to read the full chapter:
Get full access to JAMAevidence two ways:
Subscribe to JAMAevidence
JAMAevidence is a subscription-
based website dedicated to the learning, teaching, and practicing of evidence-based medicine.
Pay Per View
Timed access to all of JAMAevidence
24 hours for $29.95
48 hours for $49.95