Evidence map›Paper›PMID 31256040›Full record

ArticleBMJ open2019

Chronic hepatitis B virus case-finding in UK populations born abroad in intermediate or high endemicity countries: an economic evaluation.

Natasha K Martin, Peter Vickerman, Salim Khakoo, Anjan Ghosh, Mary Ramsay, M Hickman, Jack Williams, Alec Miners

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
  4. Article
  5. Review
  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Natasha K MartinDepartment of Medicine, University of California San Diego, La Jolla, California, USA.ORCID 0000-0001-8344-1810
Peter VickermanPopulation Health Sciences, University of Bristol, Bristol, UK.
Salim KhakooClinical and Experimental Sciences, University of Southampton, Southampton, UK.
Anjan GhoshNHS London Borough of Bexley, London, UK.
Mary RamsayImmunisation, Public Health England, London, UK.
M HickmanPopulation Health Sciences, University of Bristol, Bristol, UK.
Jack WilliamsPublic Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Alec MinersPublic Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Funding

UC San Diego Clinical and Translational Research InstituteUL1TR001442 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S, HOGARTH, MICHAEL · 2015 to 2024
$88.3M
VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Maile Ann Young Karris · 1994 to 2026
$78.4M
Modeling Structural HIV Determinants in Substance Users and related populationsR01DA037773 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA, STRATHDEE, STEFFANIE A. · 2015 to 2017
$1.4M
Medical Research Council MR/K023233/1NCATS NIH HHS UL1 TR001442NIAID NIH HHS P30 AI036214NIDA NIH HHS R01 DA037773
6 · The paper itself

Abstract

objectivesThe majority (>90%) of new or undiagnosed cases of hepatitis B virus (HBV) in the UK are among individuals born in countries with intermediate or high prevalence levels (≥2%). We evaluate the cost-effectiveness of increased HBV case-finding among UK migrant populations, based on a one-time opt out case-finding approach in a primary care setting.

designCost-effectiveness evaluation. A decision model based on a Markov approach was built to assess the progression of HBV infection with and without treatment as a result of case-finding. The model parameters, including the cost and effects of case-finding and treatment, were estimated from the literature. All costs were expressed in 2017/2018 British Pounds (GBPs) and health outcomes as quality-adjusted life-years (QALYs).

interventionHepatitis B virus case-finding among UK migrant populations born in countries with intermediate or high prevalence levels (≥2%) in a primary care setting compared with no intervention (background testing).

resultsAt a 2% hepatitis B surface antigen (HBsAg) prevalence, the case-finding intervention led to a mean incremental cost-effectiveness ratio of £13 625 per QALY gained which was 87% and 98% likely of being cost-effective at willingness to pay (WTP) thresholds of £20 000 and £30 000 per additional QALY, respectively. Sensitivity analyses indicated that the intervention would remain cost-effective under a £20 000 WTP threshold as long as HBsAg prevalence among the migrant population is at least 1%. However, the results were sensitive to a number of parameters, especially the time horizon and probability of treatment uptake.

conclusionsHBV case-finding using a one-time opt out approach in primary care settings is very likely to be cost-effective among UK migrant populations with HBsAg prevalence ≥1% if the WTP for an additional QALY is around £20 000.

Indexed as

Cost-Benefit AnalysisEpidemiological MonitoringCommunicable Diseases, ImportedEndemic DiseasesHepatitis B, ChronicHumansRisk AssessmentUnited Kingdomcase-findingeconomic evaluationhealth economicshealth services researchhepatitis B virushepatology

Identifiers

PMID31256040
PMCPMC6609059

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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.