Decision analysis in evaluation of hypergastrinemia
Hypergastrinemia and gastric acid hypersecretion are the principal laboratory features of Zollinger-Ellison syndrome. Decision and cost-effectiveness analyses were employed in the present study to compare and contrast the diagnostic strategies of initial gastric analysis followed by secretin infusio...
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| Veröffentlicht in: | The American journal of medicine 1986, Vol.80 (1), p.11-17 |
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| container_title | The American journal of medicine |
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| creator | Spindel, Enrique Harty, Richard F. Leibach, John R. McGuigan, James E. |
| description | Hypergastrinemia and gastric acid hypersecretion are the principal laboratory features of Zollinger-Ellison syndrome. Decision and cost-effectiveness analyses were employed in the present study to compare and contrast the diagnostic strategies of initial gastric analysis followed by secretin infusion test versus secretin infusion test alone in the evaluation of hypergastrinemia in patients suspected of having gastrinoma. The results of this study showed that 59 percent of patients with elevated serum gastrin values were either hypochlorhydric or achlorhydric. Application of decision analysis to either diagnostic strategy demonstrated that gastric analysis followed by secretin infusion test, if indicated, was superior in expected value than secretin infusion test alone. Likewise, in this group of patients, performance of gastric analysis in the outpatient setting prior to secretin infusion testing was financially more advantageous than performance of secretin infusion testing alone. These results also demonstrate the importance of performing gastric analysis prior to anticipated hospitalization for evaluation of suspected gastrinoma. Such testing would obviate unnecessary hospitalization and medical costs. |
| doi_str_mv | 10.1016/0002-9343(86)90042-2 |
| format | Article |
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Decision and cost-effectiveness analyses were employed in the present study to compare and contrast the diagnostic strategies of initial gastric analysis followed by secretin infusion test versus secretin infusion test alone in the evaluation of hypergastrinemia in patients suspected of having gastrinoma. The results of this study showed that 59 percent of patients with elevated serum gastrin values were either hypochlorhydric or achlorhydric. Application of decision analysis to either diagnostic strategy demonstrated that gastric analysis followed by secretin infusion test, if indicated, was superior in expected value than secretin infusion test alone. Likewise, in this group of patients, performance of gastric analysis in the outpatient setting prior to secretin infusion testing was financially more advantageous than performance of secretin infusion testing alone. 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Decision and cost-effectiveness analyses were employed in the present study to compare and contrast the diagnostic strategies of initial gastric analysis followed by secretin infusion test versus secretin infusion test alone in the evaluation of hypergastrinemia in patients suspected of having gastrinoma. The results of this study showed that 59 percent of patients with elevated serum gastrin values were either hypochlorhydric or achlorhydric. Application of decision analysis to either diagnostic strategy demonstrated that gastric analysis followed by secretin infusion test, if indicated, was superior in expected value than secretin infusion test alone. Likewise, in this group of patients, performance of gastric analysis in the outpatient setting prior to secretin infusion testing was financially more advantageous than performance of secretin infusion testing alone. These results also demonstrate the importance of performing gastric analysis prior to anticipated hospitalization for evaluation of suspected gastrinoma. Such testing would obviate unnecessary hospitalization and medical costs.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Applied sciences</subject><subject>Biological and medical sciences</subject><subject>Cost-Benefit Analysis</subject><subject>Decision Making</subject><subject>Digestive system</subject><subject>Exact sciences and technology</subject><subject>Female</subject><subject>Gastric Acid - metabolism</subject><subject>Gastric Acidity Determination</subject><subject>Gastrins - blood</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other techniques and industries</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Radioimmunoassay</subject><subject>Secretin</subject><subject>Zollinger-Ellison Syndrome - diagnosis</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1986</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LAzEQhoMotVb_gUIPInpYnXzu5iJI_YSCFz2HbDKrke1uTbaF_nu3tvSop2HmfWYYHkJOKVxToOoGAFimueCXhbrSAIJlbI8MqZQyy6li-2S4Qw7JUUpffQtaqgEZcMi1ljAk_B5dSKFtxrax9SqFNA7NGJe2XthuPW6r8edqjvHDpi6GBmfBHpODytYJT7Z1RN4fH94mz9n09ellcjfNnKCyy6TNfeHQK1-6opIlrziXSokSPVO-EgVjTGgmwWlgSlbU5RyB5Rac9bT0fEQuNnfnsf1eYOrMLCSHdW0bbBfJ5EppwVneg2IDutimFLEy8xhmNq4MBbN2ZdYizFqEKZT5dWVYv3a2vb8oZ-h3S1s5fX6-zW1ytq6ibXpXO6wApiFX_2MgORU9drvBsFe2DBhNcgGbXlCI6Drj2_D3uz_S2ZD9</recordid><startdate>1986</startdate><enddate>1986</enddate><creator>Spindel, Enrique</creator><creator>Harty, Richard F.</creator><creator>Leibach, John R.</creator><creator>McGuigan, James E.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1986</creationdate><title>Decision analysis in evaluation of hypergastrinemia</title><author>Spindel, Enrique ; Harty, Richard F. ; Leibach, John R. ; McGuigan, James E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-5a7d8ced6dbc8f5b3f335664bed26df4822249250c90265f1c73e027a0cad1bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1986</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Applied sciences</topic><topic>Biological and medical sciences</topic><topic>Cost-Benefit Analysis</topic><topic>Decision Making</topic><topic>Digestive system</topic><topic>Exact sciences and technology</topic><topic>Female</topic><topic>Gastric Acid - metabolism</topic><topic>Gastric Acidity Determination</topic><topic>Gastrins - blood</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other techniques and industries</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Radioimmunoassay</topic><topic>Secretin</topic><topic>Zollinger-Ellison Syndrome - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spindel, Enrique</creatorcontrib><creatorcontrib>Harty, Richard F.</creatorcontrib><creatorcontrib>Leibach, John R.</creatorcontrib><creatorcontrib>McGuigan, James E.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spindel, Enrique</au><au>Harty, Richard F.</au><au>Leibach, John R.</au><au>McGuigan, James E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decision analysis in evaluation of hypergastrinemia</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>1986</date><risdate>1986</risdate><volume>80</volume><issue>1</issue><spage>11</spage><epage>17</epage><pages>11-17</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>Hypergastrinemia and gastric acid hypersecretion are the principal laboratory features of Zollinger-Ellison syndrome. Decision and cost-effectiveness analyses were employed in the present study to compare and contrast the diagnostic strategies of initial gastric analysis followed by secretin infusion test versus secretin infusion test alone in the evaluation of hypergastrinemia in patients suspected of having gastrinoma. The results of this study showed that 59 percent of patients with elevated serum gastrin values were either hypochlorhydric or achlorhydric. Application of decision analysis to either diagnostic strategy demonstrated that gastric analysis followed by secretin infusion test, if indicated, was superior in expected value than secretin infusion test alone. Likewise, in this group of patients, performance of gastric analysis in the outpatient setting prior to secretin infusion testing was financially more advantageous than performance of secretin infusion testing alone. These results also demonstrate the importance of performing gastric analysis prior to anticipated hospitalization for evaluation of suspected gastrinoma. Such testing would obviate unnecessary hospitalization and medical costs.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>3079950</pmid><doi>10.1016/0002-9343(86)90042-2</doi><tpages>7</tpages></addata></record> |
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| ispartof | The American journal of medicine, 1986, Vol.80 (1), p.11-17 |
| issn | 0002-9343 1555-7162 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adolescent Adult Aged Applied sciences Biological and medical sciences Cost-Benefit Analysis Decision Making Digestive system Exact sciences and technology Female Gastric Acid - metabolism Gastric Acidity Determination Gastrins - blood Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Other techniques and industries Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Radioimmunoassay Secretin Zollinger-Ellison Syndrome - diagnosis |
| title | Decision analysis in evaluation of hypergastrinemia |
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