Table 1.

Base-case estimates

VariableBase-case analysis*Distribution for probabilistic sensitivity analysisSource
Natural history and prognosis per year, %
    Transition probabilities of gastric carcinogenesis(20)
        Normal to CAG with/without H. pylori infection3.3; 2.1β (41, 1175); β (42, 1941)
        CAG to AG6.1β (21, 327)
        AG to IM5.1β (11, 218)
        IM to gastric cancer0.25β (1, 398)
        Gastric cancer to death38β (2, 4)
    Postoperative mortality of early gastric cancer3(7)
    Survival rate of early gastric cancer97.9 (62-97.9)(6)
Primary prevention characteristics, %
    Acquisition and reinfection of H. pylori, per year1 (0.5-2.5)Norm (1, 0.2)(27, 28)
    [13C]UBT
        Attendance64.2 (20-100)Norm (60, 10)(21)
        Sensitivity97.8(29)
        Specificity96.8(29)
    H. pylori eradication with triple therapy87(21)
Secondary prevention characteristics, %
    Serum pepsinogen testing
        Attendance61.7 (20-100)Norm (60, 10)(20)
        Sensitivity for gastritis to AG70.5 (50-90)Norm (70, 10)(8-10)
        Specificity for gastritis to AG97(8-10)
    Endoscopy
        Attendance74 (30-74)Norm (50, 10)(20)
        Sensitivity93(31)
        Specificity100(31)
        Early gastric cancers among detectable cases30 (10-90)Norm (50, 10)(8, 9, 20, 21)
        Complications0.2(32)
        Mortality in patents with complications0.05(32)
Direct costs, U.S. $
        [13C]UBT36.3Triang (10-36.3-140)BNHI (33)
        Triple therapy for H. pylori eradication42.2Triang (4.2-42.2-150)BNHI (14)
        Serum pepsinogen testing19Triang (10-19-40)BNHI
        Endoscopy with biopsy68.8 (68.8-800)Triang (10-68.8-800)BNHI
        Nonfatal complication of endoscopy1,925Triang (193-1,925-16,372)NTUH (34)
        Fatal complication of endoscopy8,848Triang (885-8,848-54,000)NTUH (34)
        Initial management of early gastric cancer3,900Triang (390-3900-27779)NTUH (34)
        Initial management of advanced gastric cancer9,750Triang (975-9,750-52,000)NTUH (14)
        Continuing treatment for advanced gastric cancer294NTUH
        Incurable-cancer care8,938Triang (894-8,938-52,000)NTUH (14)
Indirect costs
    Screening time, h0.5(20, 21)
    Person accompanied for screening0(20, 21)
    Confirmation time, h1(20, 21)
    Person accompanied for confirmation0.2(20, 21)
    Inpatient hospitalization, d21BNHI
    Inpatient recovery at home, d20NTUH
    Person accompanied for inpatient care1.25NTUH
    Outpatient time per visit, h4NTUH
    Outpatient visits per year4.68BNHI
    Person accompanied for outpatient visit0.2NTUH
Average GNP per person, U.S. $15,762Triang (1,714-15,762-41,984)DGBAS
Average monthly work, h182DGBAS
Production value per hour, U.S. $7.2DGBAS
Discount rate, %3 (1-5)CBC
  • Abbreviations: AG, atrophic gastritis; BNHI, Bureau of the National Health Insurance; CAG, chronic active gastritis; CBC, Central Bank of China; DGBAS, Directorate General of Budget, Accounting and Statistics; GNP, gross national product; IM, intestinal metaplasia; NTUH, National Taiwan University Hospital; UBT, urea breath test.

  • * Data in parentheses are the range used in sensitivity analysis.

  • β (a,b) = β distribution with a transitions from b cases; Norm (a, b) = normal distribution with mean a, lower bound of 95% CI b. Triang (a,b,c) = triangular distribution with minimum a, mode b, maximum c. The base-case values were applied unless otherwise specified.

  • Numbers are reference citations.