Cost-comparison analysis of FIB-4, ELF and fibroscan in community pathways for non-alcoholic fatty liver disease

Srivastava, Ankur; Jong, Simcha; Gola, Anna; Gailer, Ruth; Morgan, Sarah; Sennett, Karen; Tanwar, Sudeep; Pizzo, Elena; O’Beirne, James; Tsochatzis, Emmanuel; Parkes, Julie; Rosenberg, William

doi:10.1186/s12876-019-1039-4

BMC Gastroenterology

Table 2 Transitional probability estimates used to populate the probabilistic analytical model for the base case (annual progression rates)

From: Cost-comparison analysis of FIB-4, ELF and fibroscan in community pathways for non-alcoholic fatty liver disease

Parameter/ Health state	Transition probability		References
Population and disease characteristics
Prevalence of advanced fibrosis in the general population	0.075		[5]
Reduction in fibrosis progression after GP management	0.01		[22], Author assumption
Reduction in fibrosis progression after specialist review	0.025		[22]
Mild/ No fibrosis (F0, F1, F2)
Remain healthy	0.99		[23,24,25,26]
Develop F3 disease	0.001		[23, 24]
Mortality (all cause)	0.005		[25, 27, 28]
Discharge from specialist services	0.7		Unpublished audit
Advanced fibrosis (F3)
Remain healthy	0.95		[25, 29, 30]
Develop F4 disease/ cirrhosis	0.04		[25, 29, 30]
Develop HCC (without cirrhosis)	0.004		[29]
Mortality (all cause)	0.005		[29]
Compensated cirrhosis (F4)
Remain compensated	0.93		Calculated from other variables
Develop varices	0.03		[31]
Develop HCC	0.003		[32, 34,35,36,37]
Develop other complications (inc. jaundice, ascites, HE)	0.02		[29, 31, 32]
Mortality (all cause)	0.02		[31, 38, 39], expert opinion
BCLC Stage 0 and A HCC
Cure (liver transplant)	0.36		[40]
Cure (non transplant)	0.39		[40]
Mortality (all cause)	0.25		[40]
BCLC stage B – D HCC
Clinical stability (post TACE, RFA etc)	0.24		[41]
Mortality (all cause)	0.76		[35]
Varices detection in surveillance programme
Clinical stability	0.92		[42]
Liver transplant	0.01		Expert opinion
Mortality (all cause)	0.07		[33]
Detection of varices after emergency presentation
Clinical stability	0.73		[43]
Liver transplant	0.02		[42]
Mortality (all cause)	0.25		[44]
Mild/ Moderate ‘other’ complication
Clinical stability	0.74		[17]
Liver transplant	0.10		[42]
Mortality (all cause)	0.16		[17]
Severe ‘other’ complication
Clinical stability	0.45		[17]
Liver transplant	0.10		[42]
Mortality (all cause)	0.45		[17]
Severity of CLD Complication	No screening	Screening
Probability of BCLC stage 0 + A HCC	0.299	0.709	[45]
Probability of BCLC stage B - D HCC	0.701	0.291	[45]
Detecting varices in surveillance programme	0.0	0.60	[42]
Detecting varices after emergency presentation	100.0	0.40	[42]
Mild/ moderate CLD ‘other’ complication	0.527	0.622	[17, 46]
Severe CLD ‘other’ complication	0.473	0.378	[17, 46]

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