Table 1 Summary of general characteristics of the studies.
| Authors/ year | Country | Data source | Aims/purpose | Study population | Intervention | Comparator |
| CBDE, common bile duct exploration; CQ, culture and quarantine; CRE, carbapenem-resistant Enterobacteriaceae; ERCP, endoscopic retrograde cholangiopancreatography; EtO, ethylene oxide; FD, fully disposable; HLD, high-level disinfection; LC, laparoscopic cholecystectomy; MDRO, multidrug-resistant microorganism; NTAP, new technology add-on payment; PD, partially disposable; SRT, surveillance and reprocessing technique; TPT, transitional pass-through payment. | ||||||
| Almario et al, 2015 12 | USA | Hypothetical cohort hospitalized and published studies | To measure cost-effectiveness of four competing strategies for CRE risk management | A hypothetical cohort of patients hospitalized for symptomatic common bile duct stones and underwent ERCP | Four competing strategies (see comparator) | 1. ERCP followed by US FDA-recommended reprocessing; 2. ERCP followed by “endoscope culture and hold”; 3. ERCP followed by EtO sterilization of the endoscope; and 4. stop ERCP in lieu of LC with CBDE |
| Barakat et al, 2022 13 | USA | Medical center and published studies | To assess cost of 6 approaches to minimize infection, taking into account duodenoscope-transmitted infection cost | Patients undergoing ERCP in tertiary care academic medical center and sterile processing division. Mean age of patients 60 years (range, 18–99) | PD duodenoscope and FD duodenoscope | Reusable duodenoscope with single HLD, double HLD, EtO sterilization, and culture and hold |
| Bomman et al, 2021 14 |
USA | Multicenter study (includes two centers with high ERCP volumes) | To estimate economic impacts of 3 commonly used enhanced-SRT compared to single HLD for performing ERCP | Patients undergoing ERCP in two institutions (Virginia Mason Medical Centre, Seattle and University of California Los Angeles, CA adopted enhanced-SRT) | Three used enhanced-SRT (Double HLD, EtO gas sterilization and CQ) for reusable duodenoscope | Single HLD for reusable duodenoscope |
| Das et al, 2022 15 | USA | Simulated cohort, hospital and published studies | To estimate cost-effectiveness of EXALT single-use duodenoscope versus current duodenoscope | Simulated cohort undergoing ERCP. Sub analysis for ERCP for Medicare patients in both hospital outpatient for TPT; hospital inpatient for NTAP. Age: 50 (20–90) | Single-use duodenoscope: (EXALT Model D, Boston Scientific Corp) | Reusable duodenoscope with current reprocessing methods (Standard HLD, CQ, EtO sterilization) |
| Kwakman et al, 2023 16 | The Netherlands, USA | Medical center and published studies | To investigate costs associated with two scenarios in which single-use duodenoscopes are used in patients carrying MDROs | Two crossover scenarios, selected patients were treated with single-use duodenoscopes (ERCP) instead of regular reusable duodenoscopes, depending on MDRO carrier status. It was in the Erasmus Medical Centre: Rotterdam, US healthcare | Single-use duodenoscope | Reusable duodenoscope: (Pentax Medical, Dodewaard; Olympus, Zoeterwoude) |
| Nicolas-Perez et al, 2024 17 | Spain | Hypothetical cohort hospitalized and published studies | To investigate cost-effectiveness of reusable duodenoscope versus a mixed option that also includes use of a single-use duodenoscope | A hypothetical cohort of 300 patients undergoing ERCP in Hospital Universitario de Canarias | Single-use duodenoscope: (EXALT Model D, Boston Scientific Corp: base-case; Ambu aScope Duodenum) | Reusable duodenoscope |
| Travis et al, 2020 18 | Denmark | Clinical data and published studies | To investigate expected incremental costs and patient outcomes of using a reusable duodenoscope versus single-use Ambu aScope Duodenoscope | Patients undergone an ERCP | Single-use duodenoscope: (Ambu aScope Duodeno) | Reusable duodenoscope |