ArticlePloS one2016
Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Cost-Effectiveness of Competing Treatment Strategies for Clostridium difficile Infection: A Systematic Review.Infection control and hospital epidemiology · 2018Pooled it
- A Systematic Literature Review of Economic Evaluations of Antibiotic Treatments for Clostridium difficile Infection.PharmacoEconomics · 2017Pooled it
- Fidaxomicin to prevent recurrentJAC-antimicrobial resistance · 2023Article
- Is Three Company or a Crowd? Comparing and Contrasting U.S. and EuropeanAntibiotics (Basel, Switzerland) · 2022Review
- Health economic evaluations comparing faecal microbiota transplantation with antibiotics for treatment of recurrent Clostridioides difficile infection: a systematic review.Health economics review · 2021Review
- Economic burden and cost-effectiveness of therapies forTherapeutic advances in gastroenterology · 2021Review
- Economic evaluation of Faecal microbiota transplantation compared to antibiotics for the treatment of recurrentEClinicalMedicine · 2020Article
- Cost-Effectiveness Analysis of Four Common Diagnostic Methods for Clostridioides difficile Infection.Journal of general internal medicine · 2020Article
- Fecal microbiota transplantation beyond Clostridioides difficile infections.EBioMedicine · 2019Review
- Quality of life and utility decrement associated with Clostridium difficile infection in a French hospital setting.Health and quality of life outcomes · 2019Article
- Cost savings following faecal microbiota transplantation for recurrentTherapeutic advances in gastroenterology · 2019Article
- Treatment of recurrentGastroenterology report · 2018Review
- Economic evaluation of interventions designed to reduce Clostridium difficile infection.PloS one · 2018Article
- Article
- [Fecal microbiota transplantation].Der Internist · 2017Review
- Article
- Review
- Fecal Microbiota-based Therapeutics for Recurrent Clostridium difficile Infection, Ulcerative Colitis and Obesity.EBioMedicine · 2016Review
- Management ofGastroenterology & hepatology · 2016Article
- Editorial Commentary: Where to Place the New Treatments for Clostridium difficile Infection?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. PERSPECTIVE: Public insurer for all hospital and physician services.
settingOntario, Canada.
methodsA decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained.
resultsFecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole.
conclusionFecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.