ArticleClinical and translational gastroenterology2017
Cost-Effectiveness of Risk Score-Stratified Hepatocellular Carcinoma Screening in Patients with Cirrhosis.
Article in Clinical and translational gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
108 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- AGA Clinical Practice Update on Risk Stratification and Emerging Surveillance Strategies for Hepatocellular Carcinoma: Expert Review.Gastroenterology · 2026Guideline
- [Guideline for stratified screening and surveillance of primary liver cancer(2020 Edition)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2021Guideline
- Surveillance Imaging and Alpha Fetoprotein for Early Detection of Hepatocellular Carcinoma in Patients With Cirrhosis: A Meta-analysis.Gastroenterology · 2018Pooled it
- Impact of Add-On Hepatobiliary Abbreviated Magnetic Resonance Imaging on Ultrasound Hepatoma Surveillance for Liver Cirrhosis- a Randomized Study.The Kaohsiung journal of medical sciences · 2026Trial
- Financial Burden of Hepatocellular Carcinoma Screening in Patients With Cirrhosis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Trial
- Hepatocellular carcinoma surveillance may be associated with potential psychological harms in patients with cirrhosis.Hepatology (Baltimore, Md.) · 2024Trial
- Cost-effectiveness of HES V2.0 and GALAD for hepatocellular carcinoma surveillance in patients with cirrhosis.Hepatology communications · 2026Article
- Cancer Detection and Surveillance Pathways with Abbreviated MRI in the Prostate, Pancreas, and Liver: A Risk-Stratified Narrative Review.Current oncology (Toronto, Ont.) · 2026Review
- Risk Assessment and Prediction of Hepatocellular Carcinoma in Noncirrhotic Metabolic Dysfunction-Associated Steatotic Liver Disease.International journal of molecular sciences · 2026Review
- Risk-stratified surveillance for hepatocellular carcinoma.Hepatology communications · 2026Review
- Hepatocellular carcinoma surveillance: a health economic evaluation.Clinical and molecular hepatology · 2026Review
- Cost-Effectiveness of Risk-Score-Based Surveillance Strategies for Hepatocellular Carcinoma in Patients with Chronic Hepatitis B.Digestive diseases and sciences · 2026Article
- Practice changing RCT design and rationale: Abbreviated MRI plus AFPJHEP reports : innovation in hepatology · 2026Review
- Cost-effectiveness analysis of artificial intelligence (AI) in earlier detection of liver lesions in cirrhotic patients at risk of hepatocellular carcinoma in Italy.Journal of medical economics · 2025Article
- Alternative Surveillance Improves Outcomes by Detecting Early-Stage Hepatocellular Carcinoma in Chronic Hepatitis B Patients.Gut and liver · 2025Article
- Exam quality of ultrasound and dynamic contrast-enhanced abbreviated MRI and impact on early-stage HCC detection.Abdominal radiology (New York) · 2025Article
- Patient centered HCC surveillance - complementary roles of ultrasound and CT/MRI.Abdominal radiology (New York) · 2025Review
- Abbreviated MRI-Based Surveillance Strategies for Early Hepatocellular Carcinoma Detection.Journal of the Korean Society of Radiology · 2025Review
- Multicenter evaluation of abbreviated MRI and ultrasound for detecting early-stage hepatocellular carcinoma.JHEP reports : innovation in hepatology · 2025Article
- New insights into biomarkers and risk stratification to predict hepatocellular cancer.Molecular medicine (Cambridge, Mass.) · 2025Review
48 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectivesHepatocellular carcinoma (HCC) surveillance with biannual ultrasound is currently recommended for all patients with cirrhosis. However, clinical implementation of this "one-size-fits-all" approach is challenging as evidenced by its low application rate. We aimed to evaluate the cost-effectiveness of risk-stratified HCC surveillance strategies in patients with cirrhosis.
methodsA Markov decision-analytic modeling was performed to simulate a cohort of 50-year-old subjects with compensated cirrhosis. Risk-stratified HCC surveillance strategies was implemented, in which patients were stratified into high-, intermediate-, or low-risk groups by HCC risk biomarker-based scores and assigned to surveillance modalities tailored to HCC risk (2 non-risk-stratified and 14 risk-stratified strategies) and compared with non-stratified biannual ultrasound.
resultsQuality-adjusted life expectancy gains for biannual ultrasound in all patients and risk-stratified strategies compared with no surveillance were 1.3 and 0.9-2.1 years, respectively. Compared with the current standard of biannual ultrasound in all cirrhosis patients, risk-stratified strategies applying magnetic resonance imaging (MRI) and/or ultrasound only in high- and intermediate-risk patients, without screening in low-risk patients, were cost-effective. Abbreviated MRI (AMRI) for high- and intermediate-risk patients had the lowest incremental cost-effectiveness ratio (ICER) of $2,100 per quality-adjusted life year gained. AMRI in intermediate- and high-risk patients had ICERs <$3,000 across a wide range of HCC incidences.
conclusionsRisk-stratified HCC surveillance strategies targeting high- and intermediate-risk patients with cirrhosis are cost-effective and outperform the currently recommended non-stratified biannual ultrasound in all patients with cirrhosis.
Identifiers
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Registered trials
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.