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Table 1 Summary of intervention input parameters to the Markov model for a H. pylori screening program in New Zealand

From: A screening program to test and treat for Helicobacter pylori infection: Cost-utility analysis by age, sex and ethnicity

  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]
  1. Confidence intervals (CI) (95%) and uncertainty ranges (also assumed to be 95%) were used to calculate standard deviations for uncertainty intervals (UIs) using a Beta distribution for proportions and a normal distribution for scalars. There are also multiple baseline input parameters not included in this table (e.g. gastric cancer rates by sex by age by ethnic group, competing background mortality rates and health system costs for a gastric cancer patient); see text
  2. OAC omeprazole, amoxicillin and clarithromycin, OBTM omeprazole, bismuth/De-Nol, tetracycline and metronidazole, non-Māori includes Pacific, Asian, European and Other ethnic groups
  3. aContributes to the effect size and the screening pathway
  4. bApplied the same standard error as for the OAC eradication rate