{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:01:04Z","timestamp":1784030464707,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,7,4]],"date-time":"2020-07-04T00:00:00Z","timestamp":1593820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1\u2010TR\u2010001857"],"award-info":[{"award-number":["UL1\u2010TR\u2010001857"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["63922\u201017"],"award-info":[{"award-number":["63922\u201017"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Children with chronic intestinal failure have a high prevalence of anemia, commonly from iron deficiency, leading to frequent blood transfusions. No current guideline exists for iron supplementation in these children. In this analysis, we evaluate the effectiveness and the cost\u2010effectiveness of using parenteral, enteral, and no iron supplementation to reduce blood transfusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We created a microsimulation model of pediatric intestinal failure over a 1\u2010year time horizon. Model outcomes included cost (US dollars), blood transfusions received, and hemoglobin trend. Strategies tested included no supplementation, daily enteral supplementation, and monthly parenteral supplementation. We estimated parameters for the model using an institutional cohort of 55 patients. Model parameters updated each 1\u2010month cycle using 2 regressions. A multivariate mixed\u2010effects linear regression estimated hemoglobin values at the next month based on data from the prior month. A mixed\u2010effects logistic regression on hemoglobin predicted the probability of receiving a blood transfusion in a given month.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with no supplementation, both enteral and parenteral iron supplementation reduced blood transfusions required per patient by 0.3 and 0.5 transfusions per year, respectively. Enteral iron cost $34 per avoided blood transfusion. Parenteral iron cost an additional $6600 per avoided blood transfusion compared with enteral iron.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found both parenteral and enteral iron to be effective at reducing blood transfusions. The cost of enteral iron makes it the desired choice in patients who can tolerate it. Future work should aim to identify which subpopulations of patients may benefit most from one strategy over the other.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.1940","type":"journal-article","created":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T13:26:05Z","timestamp":1591622765000},"page":"810-817","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Microsimulation Model to Compare Enteral and Parenteral Iron Supplementation in Children With Intestinal Failure"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6555-9732","authenticated-orcid":false,"given":"Vikram Kalathur","family":"Raghu","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Hepatology and Nutrition UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Rudolph","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Hepatology and Nutrition UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawre J.","family":"Jalal","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Graduate School of Public Health University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth J.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.03.062"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.12.049"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.07.015"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115587329"},{"key":"e_1_2_8_6_1","unstructured":"Pharmaceutical pricing data for all VA National Acquisition Center (NAC) programs. Accessed January 15 2019.https:\/\/www.va.gov\/opal\/docs\/nac\/fss\/vaFssPharmPrices.xlsx."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V71.5.1402.1402"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000619"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12847"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.25.122.110"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_8_13_1","unstructured":"deBenoistB.Iron Deficiency Anaemia Assessment Prevention and Control: A guide for programme managers. 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