ArticleCMAJ open2017
Model-based projection of health and economic effects of screening for hepatitis C in Canada.
Article in CMAJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 5 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
20 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Population-Based Testing for Undiagnosed Hepatitis C: A Systematic Review of Economic Evaluations.Applied health economics and health policy · 2022Pooled it
- Is the universal population Hepatitis C virus screening a cost-effective strategy? A systematic review of the economic evidence.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2020Pooled it
- Estimation of fibrosis progression rates for chronic hepatitis C: a systematic review and meta-analysis update.BMJ open · 2019Pooled it
- The Effectiveness and Cost-Effectiveness of Hepatitis C Screening for Migrants in the EU/EEA: A Systematic Review.International journal of environmental research and public health · 2018Pooled it
- Recommendations on hepatitis C screening for adults.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Guideline
- Economic evaluations of the primary prevention programs for viral hepatitis-related liver disease and liver cancer: a systematic literature review.Cost effectiveness and resource allocation : C/E · 2026Review
- Hepatitis C Screening: A Health Technology Assessment.Ontario health technology assessment series · 2026Article
- The Impact of New Direct-Acting Antiviral Therapy on the Prevalence and Undiagnosed Proportion of Chronic Hepatitis C Infection in Alberta: A Model-Based Analysis.Canadian liver journal · 2025Article
- Bridging Hepatitis C Care Gaps: A Modeling Approach for Achieving the WHO's Targets in Ontario, Canada.Viruses · 2024Article
- Hepatitis C Attributable Healthcare Costs and Mortality among Immigrants: A Population-Based Matched Cohort Study.Canadian journal of gastroenterology & hepatology · 2024Article
- A province-by-province cost-effectiveness analysis and budget impact analysis of one-time birth cohort screening of hepatitis C virus (HCV) infection in Canada.Scientific reports · 2023Article
- Birth cohort hepatitis C antibody prevalence in real-world screening settings in Ontario.Canadian liver journal · 2022Article
- Screening Program for Imported Diseases in Immigrant Women: Analysis and Implications from a Gender-Oriented Perspective.The American journal of tropical medicine and hygiene · 2020Article
- Article
- The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Article
- Expanding treatment for hepatitis C in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Article
- Healthcare value of implementing hepatitis C screening in the adult general population in Spain.PloS one · 2018Article
- Can we afford not to screen and treat hepatitis C virus infection in Canada?Canadian liver journal · 2018Review
- Contextualizing Canada's hepatitis C virus epidemic.Canadian liver journal · 2018Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBecause most hepatitis C virus (HCV) infections are asymptomatic and often unrecognized, screening for hepatitis C has been proposed as a plausible public health strategy. We examined the health and economic consequences of a selective one-time hepatitis C screening program for specific populations in the context of current treatment patterns.
methodsWe used a state-transition model to evaluate 2 general strategies: no screening, and screen and treat with direct-acting antiviral agents. We examined these strategies for 4 different target populations (scenarios): 1) asymptomatic people not at high risk for HCV infection, 2) immigrant populations with high prevalence, 3) a birth cohort of people aged 25-64 years and 4) a birth cohort of people aged 45-64 years of age. We obtained model data from the published literature and expert opinions. We used a payer perspective, a lifetime time horizon and a 5% discount rate.
resultsScreening would prevent 49.7%, 57.4%, 64.1% and 49.6% of HCV-related deaths over the lifetime of the cohort for scenarios 1, 2, 3 and 4, respectively. Screening would produce incremental-cost-effectiveness ratios between $31 468/quality-adjusted life-year and $50 490/quality-adjusted life-year. Probabilistic sensitivity analyses indicated that the chance that screening would be cost-effective at $50 000 willingness-to-pay threshold was 39.5%, 63.2%, 58.4% and 58.1% for scenarios 1, 2, 3 and 4, respectively.
interpretationOur analyses suggest that a one-time hepatitis C screening and treatment program in Canada is likely to be cost-effective for scenarios 2, 3 and 4. The screening programs we have evaluated would identify asymptomatic people with chronic HCV infection and would enable medical treatment to be offered if needed before the development of advanced liver disease.
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.