{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:33:09Z","timestamp":1780450389114,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","award":["2022\u2010ER0906\u201000"],"award-info":[{"award-number":["2022\u2010ER0906\u201000"]}],"id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>The cost\u2010effectiveness to screen hepatic fibrosis in at\u2010risk population as recommended by several professional societies has been limited. This study aimed to investigate the cost\u2010effectiveness of this screening strategy in the expanded at\u2010risk population recently proposed by several societies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A combined model of the decision tree and Markov models was developed to compare expected costs, quality\u2010adjusted life\u2010years (QALYs) and incremental cost\u2010effectiveness ratio (ICER) between screening and no screening groups. The model included liver disease\u2010related health states and cardiovascular disease (CVD) states as a base\u2010case analysis. Screening strategy consisted of fibrosis\u20104 index (FIB\u20104) followed by vibration\u2010controlled transient elastography (VCTE) and intensive lifestyle intervention (ILI) as a treatment for diagnosed patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cost\u2010effectiveness analysis showed that screening the at\u2010risk population entailed $298 incremental costs and an additional 0.0199 QALY per patient compared to no screening (ICER $14\u2009949\/QALY). Screening was cost\u2010effective based on the implicit ICER threshold of $25\u2009000\/QALY in Korea. When the effects of ILI on CVD and extrahepatic malignancy were incorporated into the cost\u2010effectiveness model, the ICER decreased by 0.85 times from the base\u2010case analysis (ICER $12\u2009749\/QALY). In contrast, when only the effects of liver disease were considered in the model, excluding cardiovascular disease effects, ICER increased from the baseline case analysis to $16\u2009305. Even when replacing with medical costs in Japan and U.S., it remained cost\u2010effective with the estimate below the countries' ICER threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study provides compelling evidence supporting the cost\u2010effectiveness of FIB\u20104\u2010based screening the at\u2010risk population for advanced hepatic fibrosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15838","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T06:29:11Z","timestamp":1706682551000},"page":"944-954","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cost\u2010effectiveness study of <scp>FIB<\/scp>\u20104 followed by transient elastography screening strategy for advanced hepatic fibrosis in a <scp>NAFLD<\/scp> at\u2010risk population"],"prefix":"10.1111","volume":"44","author":[{"given":"Huiyul","family":"Park","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Myoungji Hospital Hanyang University College of Medicine  Goyang Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0474-048X","authenticated-orcid":false,"given":"Eileen L.","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hanyang University College of Medicine  Seoul Korea"},{"name":"Hanyang Institute of Bioscience and Biotechnology, Hanyang University  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology Hanyang University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun\u2010Hong","family":"Kwon","sequence":"additional","affiliation":[{"name":"School of 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