Download PDF
Endoscopy 2021; 53(02): 156-161
DOI: 10.1055/a-1294-0427
Innovations and brief communications

Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment

Alanna Ebigbo‡   *
1   Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
,
Christoph Römmele‡   *
1   Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
,
Christina Bartenschlager
2   Chair of Health Care Operations/Health Information Management (UNIKA-T), Faculty of Business and Economics, University of Augsburg, Augsburg, Germany
,
Selin Temizel
3   Department of Hygiene and Environmental Medicine, Universitätsklinikum Augsburg, Augsburg, Germany
,
Elisabeth Kling
4   Department of Laboratory Medicine and Microbiology, Universitätsklinikum Augsburg, Augsburg, Germany
,
Jens Brunner
2   Chair of Health Care Operations/Health Information Management (UNIKA-T), Faculty of Business and Economics, University of Augsburg, Augsburg, Germany
,
Helmut Messmann
1   Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Referred to by:

Author commentary on Alanna Ebigbo et al.Endoscopy 2021; 53(02): v10-v10
DOI: 10.1055/a-1302-1686

Abstract

Background Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed.

Method A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation.

Results ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing.

Conclusion In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.

* Both authors contributed equally


Figs. 1s – 4s, Tables 1s – 4s



Publication History

Received: 08 July 2020

Accepted: 20 October 2020

Accepted Manuscript online:
20 October 2020

Article published online:
27 January 2021

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Thompson CC, Shen L, Lee LS. COVID-19 in endoscopy: Time to do more?. Gastrointest Endosc 2020; 92: 435-439
    CrossrefPubMedGoogle Scholar
  • 2 Mizumoto K, Kagaya K, Zarebski A. et al. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosurveillance 2020; 25: 2000180
    CrossrefPubMedGoogle Scholar
  • 3 Nishiura H, Kobayashi T, Miyama T. et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect Dis 2020; 94: 154-155
    Google Scholar
  • 4 Gudbjartsson DF, Helgason A, Jonsson H. et al. Spread of SARS-CoV-2 in the Icelandic Population. NEJM 2020; 382: 2302-2315
    CrossrefPubMedGoogle Scholar
  • 5 Gupta S, Shahidi N, Gilroy N. et al. A proposal for the return to routine endoscopy during the COVID-19 pandemic. Gastrointest Endosc 2020; 92: 735-742
    CrossrefPubMedGoogle Scholar
  • 6 Hennessy B, Vicari J, Bernstein B. et al. Guidance for resuming GI endoscopy and practice operations after the COVID-19 pandemic. Gastrointest Endosc 2020; 92: 743-747.e1
    CrossrefPubMedGoogle Scholar
  • 7 World Endoscopy Organization. WEO Guidance to Endoscopists: Reopening of Endoscopy Services. Available at (Accessed 28 October 2020): http://www.worldendo.org/2020/05/12/weo-guidance-to-endoscopists-reopening-of-endoscopy-services/
    Google Scholar
  • 8 Gralnek I, Hassan C, Beilenhoff U. et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and COVID-19: An update on guidance during the post-lockdown phase and selected results from a membership survey. Endoscopy 2020; 52: 891-898
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Corral JE, Hoogenboom SA, Kröner PT. et al. COVID-19 polymerase chain reaction testing before endoscopy: an economic analysis. Gastrointest Endosc 2020; 92: 524-534.e6
    CrossrefPubMedGoogle Scholar
  • 10 Mertens P, De Vos N, Martiny D. et al. Development and potential usefulness of the COVID-19 Ag Respi-Strip diagnostic assay in a pandemic context. Front Med (Lausanne) 2020; 7: 225
    CrossrefPubMedGoogle Scholar
  • 11 Smithgall MC, Scherberkova I, Whittier S. et al. Comparison of Cepheid Xpert Xpress and Abbott ID Now to Roche cobas for the rapid detection of SARS-CoV-2. J Clin Virol 2020; 128: 104428
    Google Scholar
  • 12 Chu DK, Akl EA, Duda S. et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020; 395: 1973-1987
    CrossrefPubMedGoogle Scholar