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Screening esophagus during routine ultrasound: medical and cost benefits

Abd Elrazek, Abd Elrazek M.A.a; Eid, Khaled A.a; El-Sherif, Abd Elhalim A.a; Abd El Al, Usama M.b; El-Sherbiny, Samir M.d; Bilasy, Shymaa E.c

European Journal of Gastroenterology & Hepatology: January 2015 - Volume 27 - Issue 1 - p 8–12
doi: 10.1097/MEG.0000000000000196
Original Articles: Gastroesophageal Disease
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Objective Cost-effectiveness analysis is an approach used to determine the value of a medical care option and refers to a method used to assess the costs and health benefits of an intervention. Upon the diagnosis of liver cirrhosis, the current guidelines recommend that all cirrhotic patients have to be screened for the presence of esophageal varices by endoscopy. In addition, patients with a positive family history of esophageal cancer are screened annually. These approaches place a heavy burden on endoscopy units, and repeated testing over time may have a detrimental effect on patient compliance.

Patients and methods Following the recommendations of a recent study entitled ‘Detection of risky esophageal varices using two dimensional ultrasound: when to perform endoscopy’, the intra-abdominal portion of the esophagus of 1100 patients was divided into a hepatic group, which included 650 patients, and a nonhepatic group, which included 450 patients, who presented with manifestations of liver diseases and gastrointestinal symptoms, respectively, and were examined using standard two-dimensional ultrasound (US) to evaluate cost effectiveness, standard issues, and medical benefits using conventional US.

Results The overall effectiveness analysis of 1100 patients yielded a 41% cost standard benefit calculated to be $114 760 in a 6-month study.

Conclusion Two-dimensional US can play an important role in screening for esophageal abnormalities, thus saving money and time. The esophagus should be screened during routine conventional abdominal US.

aDepartment of Tropical, GIT and Hepatology, Al-Azhar Faculty of Medicine, Al-Azhar University, Asiut, Cairo

bDepartment of Internal Medicine, Sohag Faculty of Medicine, Sohag

cDepartment of Biochemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt

dDepartment of Internal Medicine, Hail General Hospital, Hail, Saudi Arabia

All supplementary digital content is available directly from the corresponding author.

Correspondence to Abd Elrazek M. A. Abd Elrazek, PhD, MD, Department of Tropical Medicine, GIT and Hepatology, Al-Azhar Faculty of Medicine, Asiut 721-572, Cairo, Egypt Tel: +2 0882180445; fax: +2 0882181194; e-mail: ahmadrazek@gmail.com

Received June 7, 2014

Accepted July 23, 2014

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.