{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:41:03Z","timestamp":1747186863586,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T00:00:00Z","timestamp":1573516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Chronic liver diseases (CLDs) are major health problems that require complex and costly treatments. Liver\u2010specific clinical outcome indicators (COIs) able to assist both clinicians and administrators in improving the value of care are presently lacking. The Value\u2010Based Medicine in Hepatology (VBMH) study aims to fill this gap, devising and testing a set of COIs for CLD, that could be easily collected during clinical practice. Here we report the COIs generated and recorded for patients with HBV or HCV infection at different stages of the disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<jats:bold>\/<\/jats:bold>Results<\/jats:title><jats:p>In the first phase of VBMH study, COIs were identified, based on current international guidelines and literature, using a modified Delphi method and a RAND 9\u2010point appropriateness scale. In the second phase, COIs were tested in an observational, longitudinal, prospective, multicentre study based in Lombardy, Italy. Eighteen COIs were identified for HBV and HCV patients. Patients with CLD secondary to HBV (547) or HCV (1391) were enrolled over an 18\u2010month period and followed for a median of 4\u00a0years. The estimation of the proposed COIs was feasible in the real\u2010word clinical practice and COI values compared well with literature data. Further, the COIs were able to capture the impact of new effective treatments like direct\u2010acting antivirals (DAAs) in the clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The COIs efficiently measured clinical outcomes at different stages of CLDs. While specific clinical practice settings and related healthcare systems may modify their implementation, these indicators will represent an important component of the tools for a value\u2010based approach in hepatology and will positively affect care delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14285","type":"journal-article","created":{"date-parts":[[2019,10,26]],"date-time":"2019-10-26T15:33:48Z","timestamp":1572104028000},"page":"60-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical outcome indicators in chronic hepatitis B and C: A primer for value\u2010based medicine in hepatology"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1995-6331","authenticated-orcid":false,"given":"Mario","family":"Strazzabosco","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery University of Milan\u2010Bicocca Milan Italy"},{"name":"International Center for Digestive Health University of Milan\u2010Bicocca Milan Italy"},{"name":"Liver Center &amp; Section of Digestive Diseases Department of Internal Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-4473","authenticated-orcid":false,"given":"Paolo A.","family":"Cortesi","sequence":"additional","affiliation":[{"name":"Research Centre on Public Health (CESP) University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Conti","sequence":"additional","affiliation":[{"name":"Research Centre on Public Health (CESP) University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1189-5631","authenticated-orcid":false,"given":"Stefano","family":"Okolicsanyi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milan\u2010Bicocca Milan Italy"},{"name":"International Center for Digestive Health University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Rota","sequence":"additional","affiliation":[{"name":"Research Centre on Public Health (CESP) University of Milan\u2010Bicocca Milan Italy"},{"name":"Department of Molecular and Traslational Medicine University of Brescia Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Ciaccio","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milan\u2010Bicocca Milan Italy"},{"name":"International Center for Digestive Health University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Cozzolino","sequence":"additional","affiliation":[{"name":"Research Centre on Public Health (CESP) University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Fornari","sequence":"additional","affiliation":[{"name":"Research Centre on Public Health (CESP) University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Gemma","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milan\u2010Bicocca Milan Italy"},{"name":"International Center for Digestive Health University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana","family":"Scalone","sequence":"additional","affiliation":[{"name":"Research Centre on Public Health (CESP) University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Cesana","sequence":"additional","affiliation":[{"name":"Research Centre on Public Health (CESP) University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8538-6317","authenticated-orcid":false,"given":"Luca","family":"Fabris","sequence":"additional","affiliation":[{"name":"International Center for Digestive Health University of Milan\u2010Bicocca Milan Italy"},{"name":"Liver Center &amp; Section of Digestive Diseases Department of Internal Medicine Yale University School of Medicine New Haven CT USA"},{"name":"Department of Molecular Medicine University of Padua School of Medicine Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Colledan","sequence":"additional","affiliation":[{"name":"Department of Surgery Papa Giovanni XXIII Hospital Bergamo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Fagiuoli","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Papa Giovanni XXIII Hospital Bergamo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Ideo","sequence":"additional","affiliation":[{"name":"FADE Foundation Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Zavaglia","sequence":"additional","affiliation":[{"name":"Hepatology and Gastroenterology Unit \u2010 Liver Unit ASST GOM Niguarda Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Perricone","sequence":"additional","affiliation":[{"name":"Hepatology and Gastroenterology Unit \u2010 Liver Unit ASST GOM Niguarda Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca M.","family":"Munari","sequence":"additional","affiliation":[{"name":"FADE Foundation Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo G.","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Research Centre on Public Health (CESP) University of Milan\u2010Bicocca Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8714-2439","authenticated-orcid":false,"given":"Luca S.","family":"Belli","sequence":"additional","affiliation":[{"name":"International Center for Digestive Health University of Milan\u2010Bicocca Milan Italy"},{"name":"Hepatology and Gastroenterology Unit \u2010 Liver Unit ASST GOM Niguarda Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26645"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28527"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29042"},{"volume-title":"Redefining Health Care: Creating value\u2010based competition on results","year":"2006","author":"Porter ME","key":"e_1_2_10_5_1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1011024"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-153-4-201008170-00005"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.03.028"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0020476"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0169-2070(99)00018-7"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302024"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.11.007"},{"volume-title":"The RAND\/UCLA Appropriateness Method User\u2019s Manual","year":"2001","author":"Fitch K","key":"e_1_2_10_13_1"},{"key":"e_1_2_10_14_1","unstructured":"Oxford Centre for Evidence Based Medicine.Levels of Evidence and Grades of Recommendation; 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