{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:07:39Z","timestamp":1788314859518,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["IN\u2010US\u2010989\u20105880"],"award-info":[{"award-number":["IN\u2010US\u2010989\u20105880"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The study aimed to compare the cost\u2010effectiveness of various strategies for screening for MASLD\u2010related advanced hepatic fibrosis (fibrosis stage &gt;\u20092) using the fibrosis\u20104 index (FIB\u20104) and liver stiffness measurement (LSM) by transient elastography (TE) in persons with obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We created a decision\u2010analytic model comparing three screening strategies: no screening, TE, and FIB\u20104 followed by TE. We used a Markov transition model to track liver state, with prevalence and transition probabilities specific to the population with obesity. If MASLD was detected, patients were treated with resmetirom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found an incremental cost\u2010effectiveness ratio (ICER) of $234,781 (95% CI: $232,581, $235,608) when comparing TE to no screening with a 10\u2010year interval. We note the ICER of $234,673 (95% CI: $234,033, $235,072) when comparing TE to FIB\u20104+TE. In multivariate simulations, we found no screening was most likely to be cost\u2010effective for willingness\u2010to\u2010pay for QALY below approximately $250,000.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results suggest routine screening for MASLD in obesity clinics is not cost\u2010effective with resmetirom as the available treatment. A prescreening with FIB\u20104 before TE did not increase economic efficiency.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.70005","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T05:01:21Z","timestamp":1755147681000},"page":"1845-1848","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Screening for <scp>MASLD<\/scp> and Advanced Fibrosis Among Patients With Obesity: A Cost\u2010Effectiveness Analysis"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8408-8075","authenticated-orcid":false,"given":"Arpan","family":"Mohanty","sequence":"first","affiliation":[{"name":"Section of Gastroenterology Boston University Chobanian &amp; Avedisian School of Medicine and Boston Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3554-656X","authenticated-orcid":false,"given":"Yin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Tulane School of Public Health and Tropical Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Stoecker","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Tulane School of Public Health and Tropical Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2022.12.005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000323"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2022.03.010"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0942"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/cob.12263"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/NT.0000000000000092"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.07.050"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.47102\/annals-acadmedsg.2022284"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000262"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000191"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15730"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000609"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00317-X"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2309000"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540150055031"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.16119"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.04.017"}],"container-title":["Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/oby.70005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T02:45:05Z","timestamp":1759113905000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/oby.70005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/oby.70005"],"URL":"https:\/\/doi.org\/10.1002\/oby.70005","archive":["Portico"],"relation":{},"ISSN":["1930-7381","1930-739X"],"issn-type":[{"value":"1930-7381","type":"print"},{"value":"1930-739X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]},"assertion":[{"value":"2025-02-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}