Tag Archives: health

Opportunity Costs with Auricular Stimulation in Adolescents with Irritable Bowel Syndrome

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E Shah et al. JPGN 2024; 78: 608–613. Percutaneous electrical nerve field stimulation for adolescents with irritable bowel syndrome: Cost‐benefit and cost‐minimization analysis

Background: “Despite its favorable efficacy and safety profile, access to PENFS and other modalities in IBS can be limited by insurance coverage.”

Methods: The authors performed an economic analysis to estimate cost‐savings for patients’ families and healthcare insurance, and health outcomes, based on abdominal pain improvement with percutaneous electrical nerve field stimulation (PENFS) with IB‐Stim® (Neuraxis). The authors created a a Markov model.

Key findings:

  • PENFS was associated with 18 added healthy days over 1 year of follow‐up, increased annual parental wages of $5,802 due to fewer missed work days to care for the child, and $4744 in cost‐savings to insurance
  • Important Limitation: The economic benefits that derive from the clinical improvements used in this analysis are based on a small prospective cohort study of 20 patients with up to 1 year of follow‐up

My take: It appears that auricular stimulation should be positioned earlier in treatment algorithms for adolescents with IBS based on safety, and efficacy, especially if cost is not prohibitive.

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An easy tool to assess cardiometabolic risk

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There are a large number of anthropometrics to assess nutrition; however, simplifying the assessment would facilitate broader usage.  To that end, a recent publication suggests that checking triglyceride level and waist circumference is helpful to identify cardiometabolic risk (J Pediatr 2013; 162: 746-52).

This study used a cross-sectional design; anthropometrics, biochemistries, and cardiorespiratory fitness were assessed in 234 participants between 10-19 years of age.

Specific measurements included the following: weight, height, waist-to-height ratio (WHTR), lipid panel, blood pressure, and a cardiorespiratory fitness (CRF) as assessed by a progressive cycle ergometer tests.  The authors defined a HW or hypertriglyceridemic waist phenotype characterized as having a triglyceride ≥110 mg/dL and a waist circumference ≥ 90% for age/sex.

Key findings:

  • Participants with the HW phenotype were unlikely to have a high CRF (OR 0.045).  In addition, they had a high likelihood of elevated LDL (OR 4.41), impaired fasting blood glucose (OR 3.37).
  • Those with high WHTR were at higher odds for having low HDL (OR 2.57), high diastolic BP (OR 3.21) compared with normal WHTR participants.