{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T09:24:12Z","timestamp":1772789052339,"version":"3.50.1"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270551"],"award-info":[{"award-number":["82270551"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015401","name":"Key Research and Development Projects of Shaanxi Province","doi-asserted-by":"publisher","award":["2024SF-GJHX-16"],"award-info":[{"award-number":["2024SF-GJHX-16"]}],"id":[{"id":"10.13039\/501100015401","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015401","name":"Key Research and Development Projects of Shaanxi Province","doi-asserted-by":"publisher","award":["2024SF-YBXM-141"],"award-info":[{"award-number":["2024SF-YBXM-141"]}],"id":[{"id":"10.13039\/501100015401","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background &amp;amp; Aims<\/jats:title>\n                    <jats:p>The Baveno consensus recommends using liver stiffness measurement (LSM) and platelet count to avoid endoscopy in low-risk patients with compensated advanced chronic liver disease (cACLD). This study aimed to compare the cost-effectiveness of the Baveno-based selective screening vs. universal screening strategy for high-risk varices (HRV) in a Chinese cACLD cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A state-transition Markov model was constructed from the Chinese healthcare system perspective, simulating a cohort of 1,000 patients with cACLD over a five-year horizon. Model inputs were derived from Chinese real-world data, meta-analyses, and national fee schedules. Outcomes included costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), bleeding events, and endoscopic volumes. Sensitivity analyses and scenario analyses were performed to assess the uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The selective screening strategy yielded additional QALYs gain (3.4780 vs. 3.4452) and higher cost ($581 vs. $512) over 5 years compared with universal screening, resulting in an incremental cost of $2,103.66 per additional QALY gained and sparing 26% of patients from initial endoscopy. This ICER falls below China's per-capita GDP-based willingness-to-pay (WTP) threshold, indicating that the selective screening is cost-effective in the Chinese context. Deterministic analysis supported these findings, and probabilistic sensitivity analysis showed that selective screening was the preferred strategy in the majority of simulations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Within China's healthcare context, the Baveno-based selective screening strategy is a cost-effective option for screening of high-risk varices in patients with cACLD, suggesting that it should be considered for widespread implementation on clinical and economic grounds.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1779291","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:40:52Z","timestamp":1772779252000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reassessing the Baveno based strategy in China: a cost-effectiveness 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