Please use this identifier to cite or link to this item: http://buratest.brunel.ac.uk/handle/2438/12207
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dc.contributor.authorCrossan, C-
dc.contributor.authorTsochatzis, EA-
dc.contributor.authorLongworth, L-
dc.contributor.authorGurusamy, K-
dc.contributor.authorPapastergiou, V-
dc.contributor.authorThalassinos, E-
dc.contributor.authorMantzoukis, K-
dc.contributor.authorRodriguez-Peralvarez, M-
dc.contributor.authorO'Brien, J-
dc.contributor.authorNoel-Storr, A-
dc.contributor.authorPapatheodoridis, GV-
dc.contributor.authorDavidson, B-
dc.contributor.authorBurroughs, AK-
dc.date.accessioned2016-02-26T15:01:48Z-
dc.date.available2016-02-01-
dc.date.available2016-02-26T15:01:48Z-
dc.date.issued2016-
dc.identifier.citationJournal of Viral Hepatitis, 23(2): pp. 139 - 149, (2016)en_US
dc.identifier.issn1352-0504-
dc.identifier.urihttp://onlinelibrary.wiley.com/doi/10.1111/jvh.12469/abstract-
dc.identifier.urihttp://bura.brunel.ac.uk/handle/2438/12207-
dc.description.abstractWe compared the cost-effectiveness of various noninvasive tests (NITs) in patients with chronic hepatitis B and elevated transaminases and/or viral load who would normally undergo liver biopsy to inform treatment decisions. We searched various databases until April 2012. We conducted a systematic review and meta-analysis to calculate the diagnostic accuracy of various NITs using a bivariate random-effects model. We constructed a probabilistic decision analytical model to estimate health care costs and outcomes quality-adjusted-life-years (QALYs) using data from the meta-analysis, literature, and national UK data. We compared the cost-effectiveness of four decision-making strategies: testing with NITs and treating patients with fibrosis stage ≥F2, testing with liver biopsy and treating patients with ≥F2, treat none (watchful waiting) and treat all irrespective of fibrosis. Treating all patients without prior fibrosis assessment had an incremental cost-effectiveness ratio (ICER) of £28 137 per additional QALY gained for HBeAg-negative patients. For HBeAg-positive patients, using Fibroscan was the most cost-effective option with an ICER of £23 345. The base case results remained robust in the majority of sensitivity analyses, but were sensitive to changes in the ≥F2 prevalence and the benefit of treatment in patients with F0–F1. For HBeAg-negative patients, strategies excluding NITs were the most cost-effective: treating all patients regardless of fibrosis level if the high cost-effectiveness threshold of £30 000 is accepted; watchful waiting if not. For HBeAg-positive patients, using Fibroscan to identify and treat those with ≥F2 was the most cost-effective option.en_US
dc.description.sponsorshipThe analysis for Hepatitis B was part of a larger project funded by The National Institute for Health Research Health Technology Assessment (HTA project 09/114/02) and will be published in full in the Health Technology Assessment journal series. Visit the HTA programme website for more details www.hta.ac.uk/link to project page.en_US
dc.format.extent139 - 149 (11)-
dc.languageEnglish-
dc.language.isoenen_US
dc.publisherJohn Wiley & Sons Ltden_US
dc.subjectCirrhosisen_US
dc.subjectFibroscanen_US
dc.subjectFibrosisen_US
dc.subjectIncremental cost-effectiveness ratioen_US
dc.subjectPrognosisen_US
dc.subjectQuality-adjusted-life-yearsen_US
dc.titleCost-effectiveness of noninvasive liver fibrosis tests for treatment decisions in patients with chronic hepatitis B in the UK: systematic review and economic evaluationen_US
dc.typeArticleen_US
dc.identifier.doihttp://dx.doi.org/10.1111/jvh.12469-
dc.relation.isPartOfJOURNAL OF VIRAL HEPATITIS-
pubs.issue2-
pubs.publication-statusPublished-
pubs.publication-statusPublished-
pubs.publication-statusPublished-
pubs.volume23-
Appears in Collections:Dept of Life Sciences Research Papers

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