ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2013
Cost-effectiveness of universal serologic screening to prevent nontraumatic hip and vertebral fractures in patients with celiac disease.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Mass Screening Strategies for Celiac Disease in Apparently Healthy Children and Adolescents: A Systematic Review.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling.Health technology assessment (Winchester, England) · 2022Pooled it
- Systematic Literature Review of the Economic Burden of Celiac Disease.PharmacoEconomics · 2019Pooled it
- Celiac Disease, Gluten-Free Diet, and Eating Disorders: From Bench to Bedside.Foods (Basel, Switzerland) · 2024Article
- [Hip fracture due to osteomalacia secondary to celiac disease]Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2022Article
- Is mass screening for coeliac disease a wise use of resources? A health economic evaluation.BMC gastroenterology · 2021Article
- The impact of diagnosis on health-related quality of life in people with coeliac disease: a UK population-based longitudinal perspective.BMC gastroenterology · 2019Article
- Screening for celiac disease in the general population and in high-risk groups.United European gastroenterology journal · 2015Review
- Persistent mucosal damage and risk of fracture in celiac disease.The Journal of clinical endocrinology and metabolism · 2014Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsPatients with asymptomatic or poorly managed celiac disease can experience bone loss, placing them at risk for hip and vertebral fractures. We analyzed the cost-effectiveness of universal serologic screening (USS) vs symptomatic at-risk screening (SAS) strategies for celiac disease because of the risk of nontraumatic hip and vertebral fractures if untreated or undiagnosed.
methodsWe developed a lifetime Markov model of the screening strategies, each with male or female cohorts of 1000 patients who were 12 years old when screening began. We screened serum samples for levels of immunoglobulin A, compared with tissue transglutaminase and total immunoglobulin A, and findings were confirmed by mucosal biopsy. Transition probabilities and quality of life estimates were obtained from the literature. We used generalizable cost estimates and Medicare reimbursement rates and ran deterministic and probabilistic sensitivity analyses.
resultsFor men, the average lifetime costs were $8532 and $8472 for USS and SAS strategies, respectively, corresponding to average quality-adjusted life year gains of 25.511 and 25.515. Similarly for women, costs were $11,383 and $11,328 for USS and SAS strategies, respectively, corresponding to quality-adjusted life year gains of 25.74 and 25.75. Compared with the current standard of care (SAS), USS produced higher average lifetime costs and lower quality of life for each sex. Deterministic and probabilistic sensitivity analyses showed that the model was robust to realistic changes in all the variables, making USS cost-ineffective on the basis of these outcomes.
conclusionsUSS and SAS are similar in lifetime costs and quality of life, although the current SAS strategy was overall more cost-effective in preventing bone loss and fractures among patients with undiagnosed or subclinical disease. On the basis of best available supportive evidence, it is more cost-effective to maintain the standard celiac screening practices, although future robust population-based evidence in other health outcomes could be leveraged to reevaluate current screening guidelines.
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