Evidence map›Paper›PMID 26135026›Full record

ArticleJournal of viral hepatitis2015

Clinical impact of treatment timing for chronic hepatitis C infection: a decision model.

M T Pho, D M Jensen, D O Meltzer, A Y Kim, B P Linas

Open access · bronzeAbstract read
In one paragraph

Article in Journal of viral hepatitis, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

M T PhoDepartment of Medicine, Sections of Hospital Medicine and of Infectious Diseases and Global Health, University of Chicago, Chicago, IL, USA.
D M JensenCenter for Liver Disease, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, IL, USA.
D O MeltzerSection of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA.
A Y KimDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
B P LinasDepartment of Medicine, Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA.
University of Chicago · USBoston University · USMassachusetts General Hospital · US

Funding

Translational ScienceP30AI042853 · NIAID · MIRIAM HOSPITAL · PI LARRY K BROWN · 1998 to 2026
$51.7M
Simulation Modeling to Improve HIV/HCV Screening, Treatment and CareR01DA031059 · NIDA · BOSTON MEDICAL CENTER · PI LINAS, BENJAMIN P. · 2012 to 2015
$2.1M
Optimizing Patient-Oriented Outcomes for Chronic Hepatitis CR00HS022433 · AHRQ · UNIVERSITY OF CHICAGO · PI PHO, MAI TUYET · 2015 to 2017
$739k
Optimizing Patient-Oriented Outcomes for Chronic Hepatitis CK99HS022433 · AHRQ · UNIVERSITY OF CHICAGO · PI PHO, MAI TUYET · 2013 to 2014
$236k
AHRQ HHS K99 HS022433AHRQ HHS K99HS022433AHRQ HHS R00 HS022433NIAID NIH HHS P30 AI042853NIDA NIH HHS R01 DA031059NIDA NIH HHS R01DA031059
6 · The paper itself

Abstract

Recent advances in the treatment of hepatitis C virus (HCV) infection have led to the availability of both highly efficacious interferon-containing and interferon-sparing regimens. However, the use of such therapies faces restrictions due to high costs. For patients who are medically eligible to receive interferon, the choice between the two will likely be impacted by preferences surrounding interferon, severity of disease, coverage policies and out-of-pocket costs. We developed a decision model to quantify the trade-offs between immediate, interferon-containing therapy and delayed, interferon-free therapy for patients with chronic, genotype 1 HCV infection. We projected the quality-adjusted life expectancy stratified by the presence or absence of cirrhosis for four strategies: (i) no treatment; (ii) immediate, one-time treatment with an interferon-containing regimen; (iii) immediate treatment as above with the opportunity for retreatment in patients who fail to achieve sustained virologic response with interferon-free therapy in 1 year; and (iv) delayed therapy with interferon-free therapy in 1 year. When compared to one-time immediate treatment with the interferon-containing regimen, delayed treatment with the interferon-free regimen in 1 year resulted in longer life expectancy, with a 0.2 quality-adjusted life year (QALY) increase in noncirrhotic patients, and a 1.1 QALY increase in patients with cirrhosis. This superiority in health benefits was lost when wait time for interferon-free therapy was greater than 3-3.2 years. In this modelling analysis, interferon-free therapy resulted in superior health benefits compared to immediate therapy with interferon until wait time exceeded 3-3.2 years. Such data can inform decision-making regarding treatment initiation for HCV as healthcare financing evolves.

Indexed as

AdultAgedAged, 80 and overAntiviral AgentsDecision Support Systems, ClinicalDrug TherapyFemaleHepatitis C, ChronicHumansLife ExpectancyMaleMiddle AgedQuality of LifeTime FactorsTreatment OutcomeAntiviral Agentsdecision analysisHCVinterferon sparingtreatment timing

Identifiers

PMID26135026
PMCPMC4515086
OpenAlexW1812612443

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.