TY - CHAP M1 - Book, Section TI - Economic Analysis A1 - Goeree, Ron A1 - Drummond, Michael F. A1 - Moayyedi, Paul A1 - Levine, Mitch ell A2 - Guyatt, Gordon A2 - Rennie, Drummond A2 - Meade, Maureen O. A2 - Cook, Deborah J. PY - 2015 T2 - Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed AB - CLINICAL SCENARIOYou are a gastroenterologist on the staff of a large community hospital in which 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 tract endoscopy for patients with dyspepsia. One possibility is to reduce upper gastrointestinal tract 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 serologic 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.You are hesitant to recommend the new approach. Some physicians believe that prompt endoscopy for all helps select the most effective treatment. Moreover, the H pylori test-and-treat strategy will save no resources if patients all undergo endoscopy anyway. Before providing your advice, you decide to seek a formal economic analysis of the H pylori test-and-treat approach compared with prompt endoscopy. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/09 UR - jamaevidence.mhmedical.com/content.aspx?aid=1183878353 ER -