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Table 2 Variables employed in the model.

From: Cost-effectiveness of six strategies for Helicobacter pyloridiagnosis and management in uninvestigated dyspepsia assuming a high resource intensity practice pattern

Variable

Mean

Distribution

95th percentile *

Reference(s)

H. pylori prevalence

0.23

Uniform

0.05 - 0.4

[3, 44, 46]

Initial ulcer status

0.10

Beta

0.025-.022

[1, 2]

Cost of IgA serology

$29

Gamma

12.53-51.34

**

Cost of IgG serology

$29

Gamma

12.53-51.34

**

Cost of stool Ag detection

$21

Gamma

6.20-44.56

**

Cost of urease breath test

$133

Gamma

28.81-316.05

**

Cost of endoscopy w/biopsy and pathologist time

$511

Gamma

156.21-2552.46

***

Cost of eradication therapy

$355

Gamma

186.55-576.02

***

Cost of 2-week PPI therapy

$40

Gamma

10.92-87.51

***

Breath test sensitivity

0.95

Triangular

0.90 - 0.98

[28, 34, 39, 41, 44]

Breath test specificity

0.96

Triangular

0.94 - 0.99

[28, 34, 39, 41, 44]

IgA serology sensitivity

0.85

Triangular

0.79 - 0.90

[27, 29–31, 38, 41, 44, 47–51]

IgA serology specificity

0.79

Triangular

0.65 - 0.85

[27, 29–31, 38, 41, 44, 47–51]

IgG serology sensitivity

0.85

Triangular

0.79 - 0.90

[27, 29–31, 38, 41, 44, 47–51]

IgG serology specificity

0.79

Triangular

0.65 - 0.85

[27, 29–31, 38, 41, 44, 47–51]

Stool Ag sensitivity

0.93

Triangular

0.90 - 0.99

[27, 30, 33–35, 37, 40–44, 52–56]

Stool Ag specificity

0.92

Triangular

0.90 - 0.99

[27, 30, 33–35, 37, 40–44, 52–56]

Probability of relief of symptoms after two weeks of triple therapy (NUD§)

0.53

Beta

0.28-0.66

[57]

Probability of relief of symptoms after two weeks of triple therapy (PUD§§)

0.49

Beta

0.28-0.70

[11]

Probability of relief of symptoms after two-week PPI trial (NUD)

0.40

Beta

0.40-0.78

Expert opinion§§§

Probability of relief of symptoms after two-week PPI trial (PUD)

0.32

Beta

0.47-0.85

[11]

Probability of relapse at one year after eradication therapy (NUD)

0.32

N/A

N/A

[57]

Probability of relapse at one year after eradication therapy (PUD)

0.37

N/A

N/A

[11]

  1. *Calculated by taking 100,000 samples from each distribution.
  2. **These estimates are based on 2009 Medicare reimbursement rates, where the mean is the 2009 midpoint national reimbursement rate as published in the 2009 Clinical Diagnostic Laboratory Fee Schedule, which is available at http://www.cms.hhs.gov/ClinicalLabFeeSched/.
  3. ***These figures are based on Medicare reimbursement rates, which are current for 2009 CPT codes and are available from the American Medical Association.
  4. §Non-ulcer dyspepsia.
  5. §§Peptic ulcer disease.
  6. §§§John C. Fang, MD, Associate Professor of Gastroenterology, University of Utah, Salt Lake City, Utah