Evidence map›Paper›PMID 39459883›Full record

Trial reportViruses2024

Variability of Hepatitis C Treatment Cascade Outcomes among People Who Inject Drugs across Geographically Diverse Clinics in the US: The HERO Study.

Snehal S Lopes, Moonseong Heo, Irene Pericot-Valverde, Brianna L Norton, Lynn E Taylor, Judith I Tsui, Shruti H Mehta, Judith Feinberg, Arthur Y Kim, Paula J Lum and 5 more

Abstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in Viruses, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

15 authors.

Snehal S LopesDepartment of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
Moonseong HeoDepartment of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.ORCID 0000-0001-7711-1209
Irene Pericot-ValverdeDepartment of Psychology, College of Behavioral, Social, and Health Sciences, Clemson University, Clemson, SC 29634, USA.ORCID 0000-0001-5814-0397
Brianna L NortonAlbert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10461, USA.
Lynn E TaylorDepartment of Pharmacy Practice and Clinical Research, University of Rhode Island, 7 Greenhouse Road, Kingston, RI 02881, USA.ORCID 0000-0002-0472-8125
Judith I TsuiDepartment of Medicine, University of Washington, 325 9th Ave., Seattle, WA 98104, USA.
Shruti H MehtaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6546, Baltimore, MD 21205, USA.
Judith FeinbergDepartment of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, 930 Chestnut Ridge Road, Morgantown, WV 26505, USA.
Arthur Y KimDivision of Infectious Diseases, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
Paula J LumDepartment of Medicine, University of California, 1001 Potrero Ave., San Francisco, CA 94110, USA.
Kimberly PageDepartment of Internal Medicine, University of New Mexico Health Sciences Center, University of New Mexico, MSC 10 5550, Albuquerque, NM 87131, USA.
Cristina Murray-KrezanDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA 15215, USA.ORCID 0000-0002-5488-1080
Jessica AndersonDepartment of Internal Medicine, University of New Mexico Health Sciences Center, University of New Mexico, MSC 10 5550, Albuquerque, NM 87131, USA.ORCID 0000-0002-1346-6059
Alain H LitwinSchool of Health Research, Clemson University, Clemson, SC 29634, USA.
The Hero Study Group

Funding

Gilead Sciences (United States)Monogram BiosciencesOrasure Technologies (United States)Patient-Centered Outcomes Research Institute HPC-1503-28122Quest Diagnostics
6 · The paper itself

Abstract

Heterogeneity of outcomes across different clinical trial study sites is often inevitable. Understanding how outcomes differ by site is important for planning future programs and studies. We examined the extent of heterogeneity of hepatitis C virus (HCV) treatment cascade outcomes among persons who inject drugs (PWIDs) across sixteen clinical sites utilized in the HERO Study-a pragmatic randomized trial of HCV treatment support. Treatment cascade outcomes included averages of overall treatment adherence and proportions of treatment initiation, treatment completion, sustained virologic response (SVR) test completion, and SVR achievement. The HERO study utilized 16 clinical sites across the United States (US): eight opioid treatment programs (OTPs) and eight community health centers (CHCs). Variability of the outcomes across the 16 clinical sites was assessed using ranges and intraclass correlation coefficients (ICC) estimated from mixed-effects linear or logistic regression models. Treatment initiation was analyzed in the intention-to-treat (ITT) sample (N = 755); treatment completion, adherence, and SVR test completion in the modified ITT (mITT) sample, which is the sample that initiated treatment (N = 623); and SVR achievement in the mITT and per-protocol (PP, N = 501) samples. Across the 16 clinical sites, the range observed in the averages of overall treatment adherence was from 68% to 81% [ICC = 0.026 (0.005, 0.054)], and the ranges of proportions observed were from 68% to 96% for treatment initiation [ICC (95% CI) = 0.086 (0.051, 0.155)], 60% to 100% for treatment completion [ICC = 0.049 (0.008, 0.215)], 54% to 95% for SVR test completion [ICC = 0.096 (0.006, 0.177)], 46% to 90% for SVR achievement in the mITT sample [ICC = 0.070 (0.014, 0.122)], and 76% to 100% for SVR achievement in the PP sample [ICC = 0.143 (0.021, 0.422)]. The variability of the outcomes across 16 US sites treating HCV among PWIDs appears to be substantial in view of the ranges and ICC values of the outcomes. It is imperative to develop tailored interventions to target the sources of variability and reduce barriers at the patient, provider, clinic, and state policy levels to facilitate more equitable access to HCV treatment and reduce heterogeneity in treatment outcomes.

Indexed as

Antiviral AgentsHepatitis CSubstance Abuse, IntravenousSustained Virologic ResponseAdultFemaleHepacivirusHumansMaleMiddle AgedTreatment OutcomeUnited StatesAntiviral Agentsclinical sitecluster randomized trialsHCV treatment cascade outcomesintraclass correlation coefficientPWID

Identifiers

PMID39459883
PMCPMC11512280

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.