Evidence map›Paper›PMID 42475226›Full record

ArticleHepatology communications2026

Cost-effectiveness of HES V2.0 and GALAD for hepatocellular carcinoma surveillance in patients with cirrhosis.

Mert Sahinkoc, Gizem S Nemutlu, Hashem B El-Serag, Mary Linton B Peters, Ali Hajjar, Anthony E Samir, Leigh Anne Dageforde, Fasiha Kanwal, Jagpreet Chhatwal

Abstract read
In one paragraph

Article in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Mert SahinkocCenter for Health Technology Assessment, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.
Gizem S NemutluCenter for Health Technology Assessment, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.
Hashem B El-SeragDepartment of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Mary Linton B PetersCenter for Health Technology Assessment, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.
Ali HajjarCenter for Health Technology Assessment, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.
Anthony E SamirRadiology, Abdominal Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Leigh Anne DagefordeDepartment of Surgery, Division of Kidney and Pancreas Transplant, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Fasiha KanwalDepartment of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Jagpreet ChhatwalCenter for Health Technology Assessment, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUltrasound-based surveillance for HCC is limited by suboptimal sensitivity and low adherence. Blood-based biomarkers are potential alternatives for routine HCC surveillance. We aimed to define optimal sensitivity, specificity, and cost parameters under which blood-based biomarkers could serve as cost-effective alternatives in patients with cirrhosis.

methodsWe developed a microsimulation model of the natural history of HCC in individuals with compensated cirrhosis. We compared the cost-effectiveness of biannual surveillance using 2 blood-based biomarkers-HES V2.0 and GALAD-versus ultrasound-based surveillance across a range of sensitivity, specificity, test costs, and adherence levels. Outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs), with a willingness-to-pay threshold of $100,000/QALY.

resultsAt a $200 test cost, the optimal HES V2.0 performance was 83.8% sensitivity and 62.4% specificity, yielding more QALYs than ultrasound-based surveillance (6790 vs. 6780 per 1000 patients) with an ICER of $27,686/QALY. The optimal GALAD performance was 65.9% sensitivity and 76.4% specificity, yielding a modest QALY increase (6782 vs. 6780 per 1000 patients) with an ICER of $21,374/QALY. HES V2.0 detected more very early-stage HCCs than ultrasound-based surveillance (50.9 vs. 42.4 per 1000 patients) but increased downstream diagnostic imaging, whereas GALAD yielded smaller QALY gains with a moderate increase in diagnostic testing. At specificity ≥80%, neither biomarker was cost-effective, but cost-effectiveness was strongly influenced by adherence and test cost.

conclusionsBlood-based biomarkers such as HES V2.0 and GALAD can be cost-effective alternatives to ultrasound-based HCC surveillance under defined performance and cost conditions. These findings provide quantitative benchmarks to guide clinical evaluation and inform the development of future blood-based strategies for early HCC detection.

Indexed as

Biomarkers, TumorCarcinoma, HepatocellularEarly Detection of CancerLiver CirrhosisLiver NeoplasmsCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansMaleMiddle AgedQuality-Adjusted Life YearsSensitivity and SpecificityUltrasonographyBiomarkers, Tumorearly detectionhealth economicsliver cancermathematical modelscreening

Identifiers

PMID42475226
PMCPMC13671613

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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.