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DC Field | Value | Language |
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dc.contributor.author | Crossan, C | - |
dc.contributor.author | Tsochatzis, EA | - |
dc.contributor.author | Longworth, L | - |
dc.contributor.author | Gurusamy, K | - |
dc.contributor.author | Papastergiou, V | - |
dc.contributor.author | Thalassinos, E | - |
dc.contributor.author | Mantzoukis, K | - |
dc.contributor.author | Rodriguez-Peralvarez, M | - |
dc.contributor.author | O'Brien, J | - |
dc.contributor.author | Noel-Storr, A | - |
dc.contributor.author | Papatheodoridis, GV | - |
dc.contributor.author | Davidson, B | - |
dc.contributor.author | Burroughs, AK | - |
dc.date.accessioned | 2016-02-26T15:01:48Z | - |
dc.date.available | 2016-02-26T15:01:48Z | - |
dc.date.issued | 2015-10-07 | - |
dc.identifier.citation | Crossan, C., Tsochatzis, E.A., Longworth, L., Gurusamy, K., Papastergiou, V., Thalassinos, E., Mantzoukis, K., Rodriguez-Peralvarez, M., O'Brien, J., Noel-Storr, A., Papatheodoridis, G.V., Davidson, B. and Burroughs, A.K. (2016) 'Cost-effectiveness of noninvasive liver fibrosis tests for treatment decisions in patients with chronic hepatitis B in the UK: Systematic review and economic evaluation', Journal of Viral Hepatitis, 23 (2), pp. 139 - 149 (11), doi: 10.1111/jvh.12469. | en_US |
dc.identifier.issn | 1352-0504 | - |
dc.identifier.uri | https://bura.brunel.ac.uk/handle/2438/12207 | - |
dc.description | The copyright line for this article was changed on 18 November 2016 after original online publication. Abbreviations: CEAF cost-effectiveness frontier. CHB chronic hepatitis B. CI confidence intervals. FN false negative. FP false positive. HBV hepatitis B virus. HCC hepatocellular carcinoma. ICER incremental cost-effectiveness ratio. NITs noninvasive tests. QUADAS Quality Assessment of Diagnostic Accuracy Studies. QUALYs quality-adjusted-life-years. TN true negative. TP true positive. | - |
dc.description.abstract | Copyright © 2015 The Authors. We compared the cost-effectiveness of various noninvasive tests (NITs) in patients with chronic hepatitis B and elevated transaminases and/or viral load who would normally undergo liver biopsy to inform treatment decisions. We searched various databases until April 2012. We conducted a systematic review and meta-analysis to calculate the diagnostic accuracy of various NITs using a bivariate random-effects model. We constructed a probabilistic decision analytical model to estimate health care costs and outcomes quality-adjusted-life-years (QALYs) using data from the meta-analysis, literature, and national UK data. We compared the cost-effectiveness of four decision-making strategies: testing with NITs and treating patients with fibrosis stage ≥F2, testing with liver biopsy and treating patients with ≥F2, treat none (watchful waiting) and treat all irrespective of fibrosis. Treating all patients without prior fibrosis assessment had an incremental cost-effectiveness ratio (ICER) of £28 137 per additional QALY gained for HBeAg-negative patients. For HBeAg-positive patients, using Fibroscan was the most cost-effective option with an ICER of £23 345. The base case results remained robust in the majority of sensitivity analyses, but were sensitive to changes in the ≥F2 prevalence and the benefit of treatment in patients with F0–F1. For HBeAg-negative patients, strategies excluding NITs were the most cost-effective: treating all patients regardless of fibrosis level if the high cost-effectiveness threshold of £30 000 is accepted; watchful waiting if not. For HBeAg-positive patients, using Fibroscan to identify and treat those with ≥F2 was the most cost-effective option. | en_US |
dc.description.sponsorship | The analysis for Hepatitis B was part of a larger project funded by The National Institute for Health Research Health Technology Assessment (HTA project 09/114/02) and will be published in full in the Health Technology Assessment journal series. Visit the HTA programme website for more details www.hta.ac.uk/link to project page. | en_US |
dc.format.extent | 139 - 149 (11) | - |
dc.format.medium | Print-Electronic | - |
dc.language | English | - |
dc.language.iso | en | en_US |
dc.publisher | John Wiley & Sons | en_US |
dc.rights | Copyright © 2015 The Authors. Journal of Viral Hepatitis Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | - |
dc.subject | cirrhosis | en_US |
dc.subject | fibroscan | en_US |
dc.subject | fibrosis | en_US |
dc.subject | incremental cost-effectiveness ratio | en_US |
dc.subject | prognosis | en_US |
dc.subject | quality-adjusted-life-years | en_US |
dc.title | Cost-effectiveness of noninvasive liver fibrosis tests for treatment decisions in patients with chronic hepatitis B in the UK: systematic review and economic evaluation | en_US |
dc.type | Article | en_US |
dc.identifier.doi | https://doi.org/10.1111/jvh.12469 | - |
dc.relation.isPartOf | Journal of Viral Hepatitis | - |
pubs.issue | 2 | - |
pubs.publication-status | Published | - |
pubs.volume | 23 | - |
dc.identifier.eissn | 1365-2893 | - |
Appears in Collections: | Health Economics Research Group (HERG) |
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