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Res."],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>\n            <jats:bold>Aim:<\/jats:bold>\n            To evaluate the cost\u2013effectiveness of seven screening strategies for chronic hepatitis B (CHB) patients in China.\n            <jats:bold>Methods:<\/jats:bold>\n            A discrete event simulation model combining a decision tree and Markov structure was developed to simulate a CHB cohort aged \u226540\u00a0years on a lifetime horizon and evaluate the costs and health outcomes (quality-adjusted life years [QALYs] gained) of ultrasonography (US), alpha-fetoprotein (AFP), protein induced by vitamin K absence-II (PIVKA-II), AFP+US, AFP+PIVKA-II, GAAD (a diagnostic algorithm based on gender and age combined with results of AFP and PIVKA-II) and GAAD+US. Epidemiologic, clinical performance, utility and cost data were obtained from the literature, expert interviews and real-world data. Uncertainties on key parameters were explored through deterministic and probabilistic sensitivity analyses (DSA and PSA).\n            <jats:bold>Results:<\/jats:bold>\n            Compared with other strategies, GAAD+US detected the most HCC patients at early stage, and GAAD was the screening strategy with the lowest average cost per HCC case diagnosed. Using 3\u00d7 China's 2022 GDP per capita ($38,233.34) as the threshold, the three strategies of US, GAAD and GAAD+US formed a cost\u2013effectiveness frontier. Screening with US, GAAD, or GAAD+US was associated with costs of $6110.46, $7622.05 and $8636.32, and QALYs of 13.18, 13.48 and 13.52, respectively. The ICER of GAAD over US was $4993.39\/QALY and the ICER of GAAD+US over GAAD was $26,691.45\/QALY, which was less than 3\u00d7 GDP per capita. Both DSA and PSA proved the stability of the results.\n            <jats:bold>Conclusion:<\/jats:bold>\n            GAAD+US was the most cost-effective strategy for early HCC diagnosis among CHB patients which could be considered as the liver cancer screening scheme for the high-risk population in China.\n          <\/jats:p>","DOI":"10.57264\/cer-2023-0146","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T09:32:52Z","timestamp":1709112772000},"source":"Crossref","is-referenced-by-count":10,"title":["Early-stage hepatocellular carcinoma screening in patients with chronic hepatitis B in China: a cost\u2013effectiveness analysis"],"prefix":"10.57264","volume":"13","author":[{"given":"Yuemin","family":"Nan","sequence":"first","affiliation":[{"name":"Department of Traditional &amp; Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osvaldo Ulises","family":"Garay","sequence":"additional","affiliation":[{"name":"Roche Diagnostics International, Rotkreuz, ZG, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianzhong","family":"Lu","sequence":"additional","affiliation":[{"name":"Roche Diagnostics (Shanghai) Co., Ltd, Shanghai, 200335, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Roche Diagnostics (Shanghai) Co., Ltd, Shanghai, 200335, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Xie","sequence":"additional","affiliation":[{"name":"Yidu Cloud (Beijing) Technology Co., Ltd, Beijing, 100083, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongyi","family":"Niu","sequence":"additional","affiliation":[{"name":"Yidu Cloud (Beijing) Technology Co., Ltd, Beijing, 100083, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Public Health, Fudan University, Shanghai, 200032, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"36897","reference":[{"key":"e_1_3_7_3_2","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1097\/MCG.0b013e3182872f29","article-title":"Epidemiology of hepatocellular carcinoma: consider the population","volume":"47","author":"Mittal S","year":"2013","unstructured":"Mittal S, El-Serag HB. 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