{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T14:07:01Z","timestamp":1781100421678,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Achieving hepatitis C virus (HCV) elimination requires innovative paradigms that overcome barriers to treatment, such as requiring pre\u2010treatment elastography or phlebotomy\u2010based fibrosis assessment. To identify patients at low risk of advanced fibrosis or decompensated cirrhosis within our HCV treatment programme, we developed and retrospectively assessed a clinical decision tool, the Decompensated Cirrhosis in Hepatitis C Evaluation Questionnaire (DCHEQ). Here we describe the development of DCHEQ and its test characteristics. We conducted a retrospective, nested, case\u2013control study within a cohort of 1743 patients with HCV enrolled in an urban HCV elimination programme. The primary analysis defined cases of decompensated cirrhosis by chart review. A secondary analysis defined cases of advanced fibrosis as those with aspartate aminotransferase (AST)\u2010platelet ratio index (APRI) &gt;\u20091.5. The primary outcome was the area under the receiver operator curve (AUC) of the total DCHEQ to predict decompensated cirrhosis. We also compared the AUC of the total DCHEQ to the AUC of components of the DHEQ. For detecting cases of decompensated cirrhosis, the total of all DCHEQ items resulted in a mean AUC\u2009=\u20090.991 (95% CI\u2009=\u20090.963\u20131.000), which was significantly better than the discrimination of any alternative combination of DCHEQ items (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.00001). For detecting cases of advanced fibrosis, the total DCHEQ score resulted in a mean AUC\u2009=\u20090.921 (95% CI\u2009=\u20090.871\u20130.966), which was superior to all other DCHEQ item combinations (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.02). DCHEQ exhibited exquisite discrimination between cases of both decompensated cirrhosis and advanced fibrosis versus controls. After prospective validation, DCHEQ could be included in test\u2010and\u2010treat HCV treatment paradigms.\n                  <\/jats:p>","DOI":"10.1111\/jvh.70180","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:35:22Z","timestamp":1777444522000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low\u2010Barrier Fibrosis Screening in Hepatitis C Treatment: The Decompensated Cirrhosis in Hepatitis C Evaluation Questionnaire"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5710-1836","authenticated-orcid":false,"given":"Hunter","family":"Spencer","sequence":"first","affiliation":[{"name":"Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Brumbach","sequence":"additional","affiliation":[{"name":"Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Geduldig","sequence":"additional","affiliation":[{"name":"Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Nelson","sequence":"additional","affiliation":[{"name":"Central City Concern  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Seaman","sequence":"additional","affiliation":[{"name":"Oregon Health &amp; Science University  Portland Oregon USA"},{"name":"Central City Concern  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Centers for Disease Control and Prevention Viral Hepatitis Surveillance \u2013 United States(2021) https:\/\/www.cdc.gov\/hepatitis\/statistics\/2021surveillance\/hepatitis\u2010c.htm."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/m16\u20102575"},{"key":"e_1_2_8_4_1","unstructured":"WHO \u201cGlobal Health Sector Strategies on Respectively HIV Viral Hepatitis and Sexually Transmitted Infections for The Period 2022\u20132030 \u201d(2022)."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939\u2010023\u201001924\u20104"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.02.008"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13583"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0101554"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2021.103247"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.3692"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2017.1400385"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2017.106"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2024.111839"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.109878"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/m21\u20103846"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac445"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107705"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy585"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.03.047"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.10.020"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13534"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.07.021"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14858"},{"issue":"11","key":"e_1_2_8_24_1","first-page":"628","article-title":"Rapid Treatment Initiation for Hepatitis C Virus Infection: Potential Benefits, Current Limitations, and Real\u2010World Examples","volume":"18","author":"Finbr\u00e5ten A. 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