International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2018, 6(1), 11-13
DOI: 10.12691/ijcd-6-1-6
Open AccessArticle

Comparing the Cost Effectiveness of a Celiac Disease Panel to a Testing Cascade

Caleb Bazyler1, and Kevin Breuel2

1Department of Sport, Exercise, Recreation, and Kinesiology, East Tennessee State University, Johnson City, TN, USA

2Department of Obstetrics, and Gynecology, East Tennessee State University Clinical Laboratories, Quillen College of Medicine, Johnson City, TN, USA

Pub. Date: April 02, 2018

Cite this paper:
Caleb Bazyler and Kevin Breuel. Comparing the Cost Effectiveness of a Celiac Disease Panel to a Testing Cascade. International Journal of Celiac Disease. 2018; 6(1):11-13. doi: 10.12691/ijcd-6-1-6


Recent reductions in healthcare funding in the United States has pressured clinical laboratories to provide the same quality of diagnostic testing with fewer resources. Testing cascades have been developed to assist in the diagnosis of various illnesses, which use fewer tests and subsequently reduce costs. However, the cost effectiveness of a celiac disease (CD) testing cascade compared to a panel is currently unknown. Therefore, the purpose of this study was to determine if a CD testing cascade was equivalent to a panel in identifying patients deemed likely for CD, and to compare their cost effectiveness in a sample of symptomatic patients from Northeast Tennessee. A retrospective analysis using a CD testing cascade was performed on 933 outpatient samples referred to our laboratory from 2012 to 2017 with a request for a celiac disease serology panel. The seroprevalence of CD for the panel and the cascade were the same in this population (1.82%, 95% binomial confidence interval: 1.06% to 2.90%). The total cost of the CD cascade was 268% less than the cost of the panel resulting in a savings of $44,705, which translates to a savings of $47.92/patient. Based on these findings, we recommend utilization of the cascade to identify patients with likely CD. In the future, creative use of novel testing strategies can have significant contributions to healthcare reform and afford patients more cost-effective clinical diagnostic testing.

healthcare reform seroprevalence celiac disease cascade

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