Hepatitis C infection risk analysis : Who should be screened ? Comparison of multiple screening strategies based on the national Hepatitis surveillance program.
Hepatitis C, an infection of high prevalence worldwide, is insidiously progressive in many.
Reduction of person-to-person spread is possible, and treatment is possible for many, particularly if offered before cirrhosis develops.
Screening for hepatitis C (HCV) would be appropriate if strategies could be developed to afford adequate sensitivity and specificity at reasonable cost.
We evaluated the performance characteristics of several screening strategies to determine the best balance between cost and performance.
The database of a national hepatitis screening program was used to define risk factors for HCV.
Features associated with increased risk for HCV by multivariable analysis were combined in various ways to construct HCV screening models.
Screening Model 1 employed a mathematical model constructed to predict the probability of hepatitis C. Using this model, testing for HCV was done if the probability of HCV was determined to be higher than 7%. Models 2 and 3 called for HCV testing if certain risk factors, stratified as socially intrusive, or nonintrusive in nature, were present.
Model 4 calls for testing for HCV only when ALT values are elevated.
Costs per case discovered were calculated for each model.
Nine thousand two-hundred sixty-nine individuals from a database of 13,997 has sufficient information to be included in the modeling studies. (...)
Mots-clés Pascal : Hépatite virale C, Virose, Infection, Virus hépatite C, Hepacivirus, Flaviviridae, Virus, Facteur risque, Dépistage, Critère sélection, Coût, Analyse avantage coût, Homme, Etats Unis, Amérique du Nord, Amérique, Appareil digestif pathologie, Foie pathologie, Economie santé
Mots-clés Pascal anglais : Viral hepatitis C, Viral disease, Infection, Hepatitis C virus, Hepacivirus, Flaviviridae, Virus, Risk factor, Medical screening, Selection criterion, Costs, Cost benefit analysis, Human, United States, North America, America, Digestive diseases, Hepatic disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0248455
Code Inist : 002B30A01C. Création : 11/09/1998.