{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:49:28Z","timestamp":1792198168725,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,10,24]],"date-time":"2016-10-24T00:00:00Z","timestamp":1477267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Heath Quality Ontario (HQO)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Liver biopsy remains the gold standard for the diagnosis of liver fibrosis, but its use as a diagnostic tool is limited by its invasive nature and high cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      The aim of this study was to systematically review the cost\u2010effectiveness of transient elastography (\n                      <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\n                      ) with and without controlled attenuation parameter (\n                      <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content>\n                      ) for the diagnosis of liver fibrosis or steatosis in patients with hepatitis B, hepatitis C, alcoholic liver disease and non\u2010alcoholic fatty liver disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An economic literature search was performed. Eligibility criteria included systematic reviews, health technology assessments or economic evaluations of\n                      <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\n                      compared to liver biopsy and other non\u2010invasive tests. After abstract screening, full\u2010text reports of potentially relevant articles were assessed in duplicate. The methodological quality of the included studies was also appraised.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The database search yielded 253 records; four cost\u2010effectiveness and four cost\u2010utility studies were included. The methodological quality of the included studies varies. High\u2010quality cost\u2010effectiveness studies not only suggested that\n                      <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\n                      is less costly but also less accurate than liver biopsy. The incremental cost\u2010effectiveness ratio (\n                      <jats:styled-content style=\"fixed-case\">ICER<\/jats:styled-content>\n                      ) of\n                      <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\n                      improves with a greater level of diagnostic accuracy and a higher degree of liver fibrosis. High\u2010quality cost\u2010utility studies indicated that\n                      <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\n                      is a cost\u2010effective alternative to biopsy with\n                      <jats:styled-content style=\"fixed-case\">ICER<\/jats:styled-content>\n                      between $9000 and $14\u00a0000 per\n                      <jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content>\n                      for patients with hepatitis C. We did not find studies that assessed the cost\u2010effectiveness of\n                      <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\n                      with\n                      <jats:styled-content style=\"fixed-case\">CAP<\/jats:styled-content>\n                      for the diagnosis of liver steatosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Transient elastography is an economically attractive alternative to liver biopsy and other non\u2010invasive diagnostic tests especially for patients with a higher degree of liver fibrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.13260","type":"journal-article","created":{"date-parts":[[2016,10,11]],"date-time":"2016-10-11T11:59:33Z","timestamp":1476187173000},"page":"851-861","source":"Crossref","is-referenced-by-count":36,"title":["Transient 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