A Systematic Review and Narrative Synthesis of Health Economic Evaluations of Hepatocellular Carcinoma Screening Strategies
| Autor: | Christopher L. Blizzard, Barbara de Graaff, Kwang Chien Yee, Andrew J. Palmer, Anh Le Tuan Nguyen, Hoa Thi Thu Nguyen |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Carcinoma Hepatocellular Cost effectiveness Cost-Benefit Analysis Context (language use) Computed tomography medicine Humans Mass Screening Patient group Intensive care medicine Ultrasonography medicine.diagnostic_test business.industry Health Policy Incidence (epidemiology) Liver Neoplasms Public Health Environmental and Occupational Health medicine.disease Magnetic Resonance Imaging Hepatocellular carcinoma Central Adiposity Quality-Adjusted Life Years alpha-Fetoproteins Tomography X-Ray Computed business Primary liver cancer |
| Zdroj: | Value in Health. 24:733-743 |
| ISSN: | 1098-3015 |
| Popis: | Objectives Many economic evaluations of hepatocellular carcinoma (HCC) screenings have been conducted; however, these vary substantially with regards to screening strategies, patient group, and setting. This review aims to report the current knowledge of the cost-effectiveness of screening and describe the published data. Methods We conducted a search of biomedical and health economic databases up to July 2020. We included full and partial health economic studies if they evaluated the costs or outcomes of HCC screening strategies. Results The review included 43 studies. Due to significant heterogeneity in key aspects across the studies, a narrative synthesis was conducted. Most studies reported using ultrasound or alpha fetoprotein as screening strategies. Screening intervals were mostly annual or biannual. Incidence, diagnostic performance, and health state utility values were the most critical parameters affecting the cost-effectiveness of screening. The majority of studies reported HCC screening to be cost-effective, with the biannual ultrasound + alpha fetoprotein standing out as the most cost-effective strategy. However, few studies considered the utilization rate, and none considered the diagnostic performance of ultrasound in the context of central adiposity. Computed tomography and magnetic resonance imaging were also evaluated, but its cost-effectiveness was still controversial. Conclusions Although many studies suggested HCC screening was cost-effective, substantial limitations of the quality of these studies means the results should be interpreted with caution. Future modeling studies should consider the impact of central adiposity on the precision of ultrasound, real-world utilization rates and projections of increased HCC incidence. |
| Databáze: | OpenAIRE |
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