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array:22 [ "pii" => "S0025775300714473" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71447-3" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71447" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:1-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4329 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 4152 "PDF" => 171 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775300714485" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71448-5" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71448" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:7-14" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3599 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 3448 "PDF" => 145 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Consumo, hábitos alimentarios y estado nutricional de la población de Reus (X): evolución de la ingestión alimentaria y de la contribución de los macronutrientes al aporte energético (1983–1999), según edad y sexo" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "7" "paginaFinal" => "14" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Food intake, dietary habits and nutritional status of the population of Reus (Catalonia, Spain) (X): evolution of the diet and macronutrients contribution to energy intake (1983–1999), by age and sex" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francesca Capdevila, Dolors Llop, Núria Guillén, Verònica Luque, Susana Pérez, Vicenç Sellés, Joan Fernández-Ballart, Carles Martí-Henneberg" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Francesca" "apellidos" => "Capdevila" ] 1 => array:2 [ "nombre" => "Dolors" "apellidos" => "Llop" ] 2 => array:2 [ "nombre" => "Núria" "apellidos" => "Guillén" ] 3 => array:2 [ "nombre" => "Verònica" "apellidos" => "Luque" ] 4 => array:2 [ "nombre" => "Susana" "apellidos" => "Pérez" ] 5 => array:2 [ "nombre" => "Vicenç" "apellidos" => "Sellés" ] 6 => array:2 [ "nombre" => "Joan" "apellidos" => "Fernández-Ballart" ] 7 => array:2 [ "nombre" => "Carles" "apellidos" => "Martí-Henneberg" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300714485?idApp=UINPBA00004N" "url" => "/00257753/0000011500000001/v1_201307291641/S0025775300714485/v1_201307291641/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Análisis coste-efectividad de dos estrategias de erradicación de <span class="elsevierStyleItalic">Helicobacter pylori</span>: resultados de un estudio prospectivo y aleatorizado en atención primaria" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1" "paginaFinal" => "6" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Fernando Gomollón, Javier Valdepérez, Roberto Garuz, Javier Fuentes, Fernando Barrera, Juana Malo, Marta Tirado, Miguel Ángel Simón" "autores" => array:8 [ 0 => array:4 [ "nombre" => "Fernando" "apellidos" => "Gomollón" "email" => array:2 [ 0 => "fgomollong@meditex.es" 1 => "fgomollon@ingenia.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Javier" "apellidos" => "Valdepérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Roberto" "apellidos" => "Garuz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Javier" "apellidos" => "Fuentes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Fernando" "apellidos" => "Barrera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Juana" "apellidos" => "Malo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Marta" "apellidos" => "Tirado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 7 => array:3 [ "nombre" => "Miguel" "apellidos" => "Ángel Simón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Aparato Digestivo. Hospital Universitario Miguel Servet." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro de Salud Actur Sur. Zaragoza." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. F. Gomollón. Condes de Aragón, 18, 2B. 50009 Zaragoza." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cost/effectiveness analysis of two strategies for <span class="elsevierStyleItalic">Helicobacter pylori</span> eradication: results of a prospective and randomized study in primary care setting" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-10-14" "fechaAceptado" => "2000-02-29" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec222472" "palabras" => array:6 [ 0 => "<span class="elsevierStyleItalic">H. pylori</span>" 1 => "Coste-efectividad" 2 => "Claritromicina" 3 => "Tratamiento erradicador" 4 => "Ensayos clínicos" 5 => "Úlcera péptica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar la efectividad y el coste de 2 estrategias en el tratamiento de la infección por <span class="elsevierStyleItalic">H. pylori</span> en la úlcera péptica, en atención primaria.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron pacientes consecutivos con diagnóstico endoscópico de úlcera péptica e infección por <span class="elsevierStyleItalic">H. pylori</span> asignados aleatoriamente a una de dos estrategias: <span class="elsevierStyleItalic">a)</span> tratamiento durante 7 días con omeprazol, metronidazol, tetraciclina y subcitrato de bismuto (pauta «cuádruple»), y si éste fracasaba, tratamiento con omeprazol, amoxicilina y claritromicina durante 7 días (OCA7), y <span class="elsevierStyleItalic">b)</span> tratamiento con la pauta OCA7, y si éste fracasaba, cruce a pauta «cuádruple». El punto de análisis era la erradicación 8 semanas después de completarse el tratamiento. Tras valorar costes directos e indirectos (euros, 1997) se hizo un análisis de coste-efectividad fundado en un árbol de decisión. Se proporcionan los intervalos de confianza del 95%.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Tras evaluar a 255 pacientes, se incluyeron 97: 48 pacientes se asignaron a la estrategia <span class="elsevierStyleItalic">a</span> y 49 a la <span class="elsevierStyleItalic">b</span>. Por intención de tratar se obtuvo la erradicación en el 72,9% (IC del 95%: 58,2–84,7) con la estrategia <span class="elsevierStyleItalic">a</span> y en el 91,8% (IC del 95%: 80,4–97,7) con la estrategia b (p < 0,05). El coste medio por caso tratado fue menor para la estrategia <span class="elsevierStyleItalic">a</span> (237 frente a 268 euros), pero el coste por caso con infección erradicada fue inferior con la estrategia <span class="elsevierStyleItalic">b</span> (320 frente a 296 euros). El análisis de sensibilidad demostró que el coste estaba determinado principalmente por la eficacia erradicadora.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La estrategia de administrar OCA7 como terapia inicial y OTBM7 para los fracasos resulta la más eficiente. La variable que determina la eficiencia en el tratamiento de la infección por <span class="elsevierStyleItalic">H. pylori</span> en atención primaria es la eficacia.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To analyze cost-effectiveness of two different strategies to treat <span class="elsevierStyleItalic">H. pylori</span> infection in peptic ulcer in the primary care setting.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Consecutive patients with endoscopic diagnosis of peptic ulcer were randomized to one of two strategies: <span class="elsevierStyleItalic">a)</span> treatment during 7 days with omeprazole, tetracycline, metronidazole and bismuth subcitrate («quadruple» therapy) and if failure second-line treatment with omeprazole, amoxycillin and clarithromycin during 7 days (OCA7), and <span class="elsevierStyleItalic">b)</span> initial treatment with OCA7 and if failure treatment with «quadruple therapy». End point was eradication 8 weeks after last treatment dose. Direct and indirect costs were estimated (euros, 1997) and a cost-effectiveness analysis using a decision-tree model was undertaken after real clinical data. 95% confidence intervals are given.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">After screening 255 patients, 97 were finally included. 48 patients were given strategy <span class="elsevierStyleItalic">a</span> and 49 strategy <span class="elsevierStyleItalic">b</span>. Eradication was obtained (intention-to-treat) in 72.9% (CI 95%: 58.2–84.7) in group <span class="elsevierStyleItalic">a</span> versus 91.8% (CI 95%: 80.4–97.7) (p < 0.05) in group <span class="elsevierStyleItalic">b</span>. Mean cost per case treated was lower in group <span class="elsevierStyleItalic">a</span> (237 versus 268 euros) but cost per case eradicated was lower in group <span class="elsevierStyleItalic">b</span> (320 versus 296 euros). The cost was primarily determined by efficacy.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Treatment with OCA7 followed by rescue with «quadruple» therapy if failure is more efficient in our area that the inverse strategy. Efficiency is mostly determined by efficacy.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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Bloom" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "1998" "volumen" => "158" "paginaInicial" => "852" "paginaFinal" => "860" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9570170" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: The MACH 1 Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Lind" 1 => "S.V. Van Zaten" 2 => "P. Unge" 3 => "R. Spiller" 4 => "E. Bayerdörffer" 5 => "C. 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