Evidence map›Paper›PMID 30311154›Full record

ArticleDigestive diseases and sciences2019

Reduced Imaging Radiation Exposure and Costs Associated with Anti-Tumor Necrosis Factor Therapy in Crohn's Disease.

Seema A Patil, Mark H Flasar, Jay Lin, Melissa Lingohr-Smith, Martha Skup, Song Wang, Jingdong Chao, Raymond K Cross

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Seema A PatilUniversity of Maryland, 685 W. Baltimore St., Suite 8-00, Baltimore, MD, 21201, USA.
Mark H FlasarAnne Arundel Gastroenterology Associates, 820 Bestgate Rd, Annapolis, MD, 21401, USA.
Jay LinNovosys Health, 7 Crestmont Court, Flemington, NJ, 08822-6933, USA.
Melissa Lingohr-SmithNovosys Health, 7 Crestmont Court, Flemington, NJ, 08822-6933, USA.
Martha SkupAbbVie, Inc, 1 N Waukegan Road, North Chicago, IL, 60064, USA.
Song WangAbbVie, Inc, 1 N Waukegan Road, North Chicago, IL, 60064, USA.
Jingdong ChaoAbbVie, Inc, 1 N Waukegan Road, North Chicago, IL, 60064, USA.
Raymond K CrossUniversity of Maryland, 685 W. Baltimore St., Suite 8-00, Baltimore, MD, 21201, USA. rcross@som.umaryland.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadiation exposure from diagnostic imaging may increase cancer risk of Crohn's disease (CD) patients, who are already at increased risk of certain cancers.

aimTo compare imaging radiation exposure and associated costs in CD patients during the year pre- and post-initiation of anti-tumor necrosis factor (anti-TNF) agents or corticosteroids.

methodsAdults were identified from a large US claims database between 1/1/2005 and 12/31/2009 with ≥ 1 abdominal imaging scan and 12 months of enrollment before and after initiating therapy with anti-TNF or corticosteroids. Imaging utilization, radiation exposure, and healthcare costs pre- and post-initiation were examined.

resultsAnti-TNF-treated patients had significantly fewer imaging examinations the year prior to initiation than corticosteroid-treated patients. Cumulative radiation doses before initiation were significantly higher for corticosteroid patients compared to anti-TNF patients (22.3 vs. 17.7 millisieverts, P = 0.0083). After therapy initiation, anti-TNF-treated patients had significantly fewer imaging examinations (2.9 vs. 5.2, P < 0.0001) and less radiation exposure (7.4 vs. 15.4 millisieverts, P <0.0001) than corticosteroid-treated patients in the follow-up period. Reductions in imaging costs adjusted for 1000 patient-years after initiation of therapy were - $275,090 and - $121,960 (P = 0.0359) for anti-TNF versus corticosteroid patients, respectively.

conclusionsThis analysis demonstrated that patients treated with anti-TNF agents have fewer imaging examinations, less radiation exposure, and lower healthcare costs associated with imaging than patients treated with corticosteroids. These benefits do not account for additional long-term benefits that may be gained from reduced radiation exposure.

Indexed as

Crohn DiseaseHealth Care CostsRadiation DosageAdolescentAdrenal Cortex HormonesAdultAgedBiological ProductsCost SavingsDatabases, FactualFemaleHumansMaleMiddle AgedPredictive Value of TestsRadiation ExposureAdrenal Cortex HormonesBiological ProductsTumor Necrosis Factor-alphaCostCrohn’s diseaseDiagnostic imagingGlucocorticoidsTumor necrosis factor-alpha

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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.