ArticleWorld journal of gastroenterology2025
Cost-effectiveness of transient elastography for liver fibrosis screening in Thai patients with diabetes mellitus.
Article in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between diabetes mellitus (DM) and metabolic dysfunction-associated steatotic liver disease (MASLD) is well documented, with DM increasing the risk of developing MASLD and liver fibrosis.
aimTo evaluate the cost-effectiveness and budget impact of transient elastography (TE) for detecting significant fibrosis in Thai patients with DM.
methodsWe conducted a lifetime cost-utility analysis from a societal perspective, combining a decision tree with a Markov model. Four alternatives were compared: Fibrosis-4 (FIB-4) index triage followed by TE, steatosis-associated fibrosis estimator (SAFE) score triage followed by TE, standalone TE, and no screening. Clinical probabilities, utilities, and costs came from previous studies and Siriraj Hospital data. Costs and quality-adjusted life-years (QALYs) were discounted 3% annually, and incremental cost-effectiveness ratios (ICERs) were judged against the 160000-Thai baht (THB; 4619 United States dollars [USD])/QALY threshold. A 5-year budget impact was evaluated from the payer perspective.
resultsAmong the screening methods evaluated, TE alone yielded the highest total lifetime costs of 200403 THB (5785 USD) and the highest QALYs of 12.81. Compared to no screening, all strategies demonstrated cost-effectiveness with ICERs of 75961, 80385, and 98965 THB (2193, 2321, and 2857 USD)/QALY gained for FIB-4 + TE, SAFE + TE, and TE alone, respectively. Extended dominance favored SAFE + TE, yet probabilistic analysis showed FIB-4 + TE had the highest cost-effectiveness probability and the smallest budget impact. Estimated annual budget impacts amounted to 470.7-755.8 million THB (13.6-21.8 million USD).
conclusionImplementing screening for significant fibrosis in patients with DM is cost-effective. In resource-limited settings, prioritizing the FIB-4 index as a triage tool before TE is recommended.
Indexed as
Identifiers
What OpenQuestion holds
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.