Evidence map›Paper›PMID 30238203›Full record

ArticleDigestive diseases and sciences2019

A Comparison Between Community and Academic Practices in the USA in the Management of Chronic Hepatitis B Patients Receiving Entecavir: Results of the ENUMERATE Study.

Hannah M Lee, Joseph Ahn, W Ray Kim, Joseph K Lim, Mindie Nguyen, Calvin Q Pan, Donghee Kim, Ajitha Mannalithara, Helen Te, Huy Trinh and 4 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

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

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Hannah M LeeDivision of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University Medical Center, 1200 E. Broad St., 14th Floor, P.O. Box 980341, Richmond, VA, 23298, USA. hannah.lee@vcuhealth.org.
Joseph AhnDivision of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR, USA.
W Ray KimDivision of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA.
Joseph K LimYale University, New Haven, CT, USA.
Mindie NguyenDivision of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA.
Calvin Q PanDivision of Gastroenterology and Hepatology, NYU Langone Health, NYU School of Medicine, New York, USA.
Donghee KimDivision of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA.
Ajitha MannalitharaDivision of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA.
Helen TeDigestive Disease Center, University of Chicago, Chicago, IL, USA.
Huy TrinhSan Jose Gastroenterology, San Jose, CA, USA.
Danny ChuAlbert Einstein College of Medicine, New York, NY, USA.
Tram TranDepartment of Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Jocelyn WoogAsian Health Foundation, Rochester, MN, USA.
Anna S LokDivision of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThe management of chronic hepatitis B patients is not well characterized in real-world practice. We compared baseline characteristics of CHB patients on entecavir, the frequency of on-treatment monitoring, and the effectiveness of ETV treatment between academic and community practices.

methodsTreatment-naïve CHB patients ≥18 years old, treated with ETV for ≥12 months from 2005 to 2013, in 26 community and academic practices throughout the USA were retrospectively evaluated.

resultsOf 841 patients enrolled, 658 (65% male, 83% Asian, median age 47, 9% with cirrhosis) met inclusion criteria. Half of the patients (52%) were from community practices. A lower percentage of patients in community practices had cirrhosis or liver cancer (5 vs. 14%). Community practices more often treated patients with baseline ALT < 2 × ULN. Over a median follow-up of 4 years, community practices were more likely to discontinue ETV with less frequent laboratory monitoring compared to academic practices. The 5-year cumulative probability of ALT normalization was greater among patients treated in community practices (70 vs. 50%, p < 0.001), but the 5-year cumulative probability of undetectable HBV DNA was lower (45 vs. 70%, p < 0.001) than those treated in academic practices.

conclusionAcademic practices saw CHB patients with more advanced liver disease, more often followed AASLD guidelines, and monitored patients on ETV treatment more frequently than community practices. While patients in community practices were less likely to achieve undetectable HBV DNA and more likely to achieve ALT normalization, the rates of HBeAg loss and seroconversion as well as HBsAg loss were similar.

Indexed as

Academic Medical CentersCommunity Health ServicesAdultAlanine TransaminaseAntiviral AgentsAsianBlack or African AmericanDeprescriptionsDNA, ViralFemaleGuanineHepatitis B, ChronicHepatitis B e AntigensHepatitis B Surface AntigensHumansLiver CirrhosisAlanine TransaminaseAntiviral AgentsDNA, ViralentecavirGuanineHepatitis B e AntigensHepatitis B Surface AntigensAntiviral therapyChronic HBVHBeAg lossHBsAg lossPractice management

Identifiers

PMID30238203

What OpenQuestion holds

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Registered trials

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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.