Table 1 Summary of intervention input parameters to the Markov model for a H. pylori screening program in New Zealand
Māori (indigenous population) central estimate (95% CI)/[95% UI] | Non-Māori (rest of NZ population) central estimate (95% CI)/[95% UI] | |
|---|---|---|
Effect size | ||
Meta-analysis rate ratio for incidence of gastric cancer in people with H. pylori infection who were treated compared to untreatedb | Both: 0.66 (0.46–0.95) | |
Proportion gastric cancer that was non-cardia gastric cancer (2007-11) | ||
Men | 0.77 (0.69–0.85) | 0.45 (0.41–0.49) |
Women | 0.89 (0.82–0.96) | 0.63 (0.58–0.69) |
Non-cardia gastric cancer where H. pylori infection is detectablea | 0.89 (0.85–1.00) | |
Sensitivity of the serology test (Se sero ) | 0.89 [0.85–0.92] [28] | |
Expected coverage of serology test (using data from routine heart and diabetes checks in NZ adults [27])a | 0.81 (0.69–0.93)b | 0.84 (0.72–0.97)b |
Eradication rate reported by studies in the meta-analysis [2] | 0.73 (0.71–0.75) | |
Eradication rate of OAC triple therapy in NZ, intention to treat [29]a | 0.64 (0.53–0.75) | 0.86 (0.75–0.96) |
Eradication rate of OBTM quadruple therapy in NZ [16]a | 0.7 [0.6–0.8] | |
Annual percentage decline in gastric cancer over time [5] | 0.02 [0.01–0.03] | |
Screening pathway | ||
H. pylori seroprevalence (proportion) by age-group (years) in 2011 [41] | ||
25–29 | 0.11 [0.07–0.14] | 0.08 [0.05–0.10] |
30–34 | 0.15 [0.11–0.20] | 0.10 [0.07–0.13] |
35–39 | 0.20 [0.14–0.25] | 0.13 [0.09–0.16] |
40–44 | 0.24 [0.17–0.31] | 0.15 [0.11–0.20] |
45–49 | 0.29 [0.20–0.37] | 0.18 [0.12–0.23] |
50–54 | 0.33 [0.23–0.43] | 0.20 [0.14–0.26] |
55–59 | 0.38 [0.26–0.49] | 0.23 [0.16–0.29] |
60–64 | 0.42 [0.29–0.55] | 0.25 [0.18–0.33] |
65–69 | 0.47 [0.33–0.60] | 0.28 [0.19–0.36] |
Risk of Clostridium difficile infection post-treatment (Brown et al., 2013) | 0.0008 [0.0004–0.0012] | |
Cost of hospitalization with moderate or severe C. difficile infection [34] | $3,856 [3085–4628] | |
Costs of screening program (NZ, 2011) (See Additional file 1: Table S2 for breakdown of costs and sources) | ||
Cost per person invited (fixed health promotion, program costs) | $39.87 [31.90–47.84] | |
Cost per person tested (test and result) | $54.66 [43.73–65.59] | |
Cost per person with a positive test (GP visit, treatment, retest, complications) | $176.70 [141.36–212.04] | |
Cost per person where eradication failed (GP visit, treatment, complications) | $129.85 [103.88–155.82] | |