Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2017; 23(17): 3163-3173
Published online May 7, 2017. doi: 10.3748/wjg.v23.i17.3163
Published online May 7, 2017. doi: 10.3748/wjg.v23.i17.3163
Cost-effectiveness of enhanced liver fibrosis test to assess liver fibrosis in chronic hepatitis C virus and alcoholic liver disease patients
Marcelo Soto, Fundació Clínic per a la Recerca Biomèdica, 08036 Barcelona, Spain
Laura Sampietro-Colom, Health Technology Assessment Unit, Hospital Clínic, Barcelona, 08036 Barcelona, Spain
Luis Lasalvia, Siemens Healthcare, Tarrytown, NY 10591, United States
Aurea Mira, Wladimiro Jiménez, Department of Clinical Microbiology, Hospital Clínic, 08036 Barcelona, Spain
Aurea Mira, Wladimiro Jiménez, Department of Biomedicine, University of Barcelona, 08036 Barcelona, Spain
Wladimiro Jiménez, Miquel Navasa, IDIBAPS, CIBERehd, 08036 Barcelona, Spain
Miquel Navasa, Liver Unit, Hospital Clínic, 08036 Barcelona, Spain
Author contributions: Soto M, Sampietro-Colom L, Lasalvia L, Mira A, Jiménez W and Navasa M conceived and designed the study; Soto M, Sampietro-Colom L and Navasa M analyzed the data; Soto M, Sampietro-Colom L, Lasalvia L and Navasa M wrote the paper.
Supported by Siemens. Marcelo Soto received financial support from Plataforma ITEMAS PT13/0006/0009 (FCRB PI043029, partially) .
Conflict-of-interest statement: Lasalvia L owns shares of Siemens and is a Siemens employee. Navasa M reports grants from Siemens, during the conduct of the study. Jiménez W reports grants from Siemens, prior the conduct of the study. Siemens has issued patents on ELF.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Marcelo Soto, Fundació Clínic per a la Recerca Biomèdica, Roselló 149-153, 08036 Barcelona, Spain. soto@clinic.ub.es
Telephone: +34-93-2271874 Fax: +34-93-2279240
Received: November 4, 2016
Peer-review started: November 21, 2016
First decision: December 28, 2016
Revised: March 3, 2017
Accepted: March 15, 2017
Article in press: March 15, 2017
Published online: May 7, 2017
Peer-review started: November 21, 2016
First decision: December 28, 2016
Revised: March 3, 2017
Accepted: March 15, 2017
Article in press: March 15, 2017
Published online: May 7, 2017
Core Tip
Core tip: Noninvasive methods to diagnose liver fibrosis have been proposed as an alternative to liver biopsy in patients with abnormal level of transaminases. In a Markov model, sequential testing with enhanced liver fibrosis (ELF) test followed by liver stiffness measurement (LSM) significantly reduce liver-related lifetime morbidity and mortality, compared with biopsy, in hepatitis C virus (HCV) and alcoholic liver disease patients. Noninvasive methods are also associated with an increase in quality-adjusted life years and costs. Overall, they are cost-effective strategies compared with biopsy. ELF test with or without a confirmation LSM may represent a more affordable strategy than the “treat-all” option in HCV patients.