Table 4

Models of diagnosis:a overall costb and numbers of investigations for screening 1,000 adult men or women in the community for CD
Screen Sex Model
A B C D E F G H
TG2 IgAc F 1,000 1,000 1,000 1,000
M 1,000 1,000 1,000 1,000
Composite TG2/DGP IgA/IgGc F 1,000 1,000 1,000
M 1,000 1,000 1,000
HLA-DQd F 1,000
M 1,000
Confirmatory test if initial test is ‘positive’
 TG2 IgAc F 560
M 557
 EMAc F 45 3 19
M 69 2 37
 TG2 IgA and DGP-G, DGP-Ae F 52
M 79
 HLA-DQd F 45 45 3 52 52
M 69 69 2 79 79
Biopsy if initial and/or confirmatory tests are positivef
 Biopsy F 45 32 32 42 18 52 38 28
M 69 45 45 67 16 79 48 24
 Cases diagnosedg F 13 13 13 13 13 19 19 19
M 13 13 13 13 13 12 12 12
 Total cost for investigations, A$ F 63,150 57,484 58,605 61,034 149,367 69,100 63,422 57,010
M 83,550 71,406 73,124 82,139 148,041 92,050 75,152 57,924
 Cost per case screened, A$ F 63 57 59 61 149 69 63 57
M 84 71 73 82 148 92 75 58
 Cost per case diagnosed, A$ F 4,858 4,422 4,508 4,695 11,490 3,637 3,338 3,001
M 6,427 5,493 5,625 6,318 11,388 7,671 6,263 4,827

Abbreviations: CD, celiac disease; DGP, Deamidated gliadin-derived peptide; EMA, endomysial antibody; HLA, human leukocyte antigen; TG, transglutaminase.

aData are n, unless otherwise stated.

bCosts are based on 100% reimbursement of Australian Medicare Benefits Schedule fee for items c71163: A$24.90, d71151: A$119.65, e71164: A$40.15, and fA$850 estimated costs of gastroscopy, histology, sedation, and hospital/clinic facility fee.

gCases diagnosed were assumed to be the excess of HLA-DQ2.5/8/2.2 subjects in those screened by TG2 IgA (models A to E), or composite antigen ELISA (model F to H), as detailed in Table 1.

Anderson et al.

Anderson et al. BMC Medicine 2013 11:188   doi:10.1186/1741-7015-11-188

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