Evidence map›Paper›PMID 37076870›Full record

ArticleBMC health services research2023

Hepatocellular carcinoma surveillance based on the Australian Consensus Guidelines: a health economic modelling study.

Anh Le Tuan Nguyen, Lei Si, John S Lubel, Nicholas Shackel, Kwang Chien Yee, Mark Wilson, Jane Bradshaw, Kerry Hardy, Andrew John Palmer, Christopher Leigh Blizzard and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.1field-weighted citation impact, top 12% 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

6 citing papers in PubMed, 10 citations in OpenAlex.

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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

11 authors at 5 institutions in 1 country.

Anh Le Tuan NguyenMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia. al.nguyen@utas.edu.au.
Lei SiSchool of Health Sciences, Western Sydney University, Campbelltown, Australia.
John S LubelAlfred Health, Melbourne, VIC, Australia.
Nicholas ShackelUniversity of New South Wales, Sydney, NSW, Australia.
Kwang Chien YeeSchool of Medicine, University of Tasmania, Hobart, TAS, Australia.
Mark WilsonSchool of Medicine, University of Tasmania, Hobart, TAS, Australia.
Jane BradshawRoyal Hobart Hospital, Hobart, TAS, Australia.
Kerry HardyRoyal Hobart Hospital, Hobart, TAS, Australia.
Andrew John PalmerMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
Christopher Leigh BlizzardMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
Barbara de GraaffMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
Royal Hobart Hospital · AUUniversity of Tasmania · AUAlfred Health · AUUNSW Sydney · AUWestern Sydney University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatocellular carcinoma (HCC) is the fastest increasing cause of cancer death in Australia. A recent Australian consensus guidelines recommended HCC surveillance for cirrhotic patients and non-cirrhotic chronic hepatitis B (CHB) patients at gender and age specific cut-offs. A cost-effectiveness model was then developed to assess surveillance strategies in Australia.

methodsA microsimulation model was used to evaluate three strategies: biannual ultrasound, biannual ultrasound with alpha-fetoprotein (AFP) and no formal surveillance for patients having one of the conditions: non-cirrhotic CHB, compensated cirrhosis or decompensated cirrhosis. One-way and probabilistic sensitivity analyses as well as scenario and threshold analyses were conducted to account for uncertainties: including exclusive surveillance of CHB, compensated cirrhosis or decompensated cirrhosis populations; impact of obesity on ultrasound sensitivity; real-world adherence rate; and different cohort's ranges of ages.

resultsSixty HCC surveillance scenarios were considered for the baseline population. The ultrasound + AFP strategy was the most cost-effective with incremental cost-effectiveness ratios (ICER) compared to no surveillance falling below the willingness-to-pay threshold of A$50,000 per quality-adjusted life year (QALY) at all age ranges. Ultrasound alone was also cost-effective, but the strategy was dominated by ultrasound + AFP. Surveillance was cost-effective in the compensated and decompensated cirrhosis populations alone (ICERs < $30,000), but not cost-effective in the CHB population (ICERs > $100,000). Obesity could decrease the diagnostic performance of ultrasound, which in turn, reduce the cost-effectiveness of ultrasound ± AFP, but the strategies remained cost-effective.

conclusionsHCC surveillance based on Australian recommendations using biannual ultrasound ± AFP was cost-effective.

Indexed as

Carcinoma, HepatocellularLiver Neoplasmsalpha-FetoproteinsAustraliaCost-Benefit AnalysisFibrosisHumansLiver Cirrhosisalpha-FetoproteinsAlpha-fetoproteinCost-effectivenessHepatocellular carcinomaSurveillanceUltrasound

Identifiers

PMID37076870
PMCPMC10116722
OpenAlexW4366448946

What OpenQuestion holds

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LicenceCC BY
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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.