PREVALENCE OF SURREPTITIOUS LAXATIVE ABUSE IN PATIENTS WITH DIARRHEA OF UNCERTAIN ORIGIN - A COST-BENEFIT ANALYSIS OF A SCREENING-PROCEDURE
PREVALENCE OF SURREPTITIOUS LAXATIVE ABUSE IN PATIENTS WITH DIARRHEA OF UNCERTAIN ORIGIN - A COST-BENEFIT ANALYSIS OF A SCREENING-PROCEDURE
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DOI：
10.1136/gut.30.10.1379
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发表时间：
1989-10-01
期刊：
影响因子：
24.5
通讯作者：
DEMUCKADELL, OBS
中科院分区：
文献类型：
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作者：
BYTZER, P;STOKHOLM, M;DEMUCKADELL, OBS
对病因不明的腹泻患者进行早期常规泻药筛查试验的成本和医疗效益进行了评估。在两年的时间里，200名连续的腹泻患者被考虑用于研究，其中进行了三天的粪便收集。54名拒绝服用泻药的患者在初次就诊时出现不明原因的腹泻（平均每日粪便重量> 200 g），其中47名患者接受了蒽醌类、比沙可啶、酚酞和镁盐摄入检测。7名患者检测呈阳性。没有一个单一的临床特征可以预测测试的结果。该方案可能节省的费用是通过在病人的调查完成之前不向临床医生公布测试结果来估计的。这7名滥用泻药的患者总共住院35天，在泻药筛查试验呈阳性后，在门诊就诊29次。筛查方案的费用比滥用泻药患者的诊断程序的费用便宜。我们建议在所有不明原因腹泻患者中使用全面的早期泻药筛查计划，作为一种具有成本效益的程序。
The costs and medical benefits of an early, routine laxative screening test in patients with diarrhoea of uncertain origin was evaluated. During a two year period 200 consecutive, unselected patients complaining of diarrhoea were considered for the study in whom a three day faecal collection was undertaken. Fifty four patients denying laxative consumption had diarrhoea (mean daily stool weight > 200 g) of uncertain origin at their initial visit of whom 47 were screened to detect ingestion of anthraquinones, bisacodyl, phenolphthalein, and magnesium salts. Seven patients had positive tests. No single clinical feature could have predicted the outcome of the test. The possible cost savings of the programme were estimated by not releasing the results of the test to the clinicians until the patient''s investigations were complete. The seven patients with laxative abuse spent a total of 35 days in hospital and were seen on 29 occasions in the outpatient clinic after the laxative screening test was positive. The cost of the screening programme was cheaper than the costs of the diagnostic procedures in patients with laxative abuse. We recommend the use of a comprehensive, early laxative screening programme in all patients with diarrhoea of uncertain origin as a cost effective procedure.