Screening for Hepatocellular Carcinoma in Chronic Liver Disease
Authors: Diana Chirovsky, Kristen Hassmiller Lich, A. Sidney Barritt
Journal: Annals of Internal Medicine (2015)

Letters3 February 2015Screening for Hepatocellular Carcinoma in Chronic Liver DiseaseDiana Chirovsky, MS, PhD, Kristen Hassmiller Lich, MHA, PhD, and A. Sidney Barritt IV, MD, MSCRDiana Chirovsky, MS, PhDFrom University of North Carolina School of Medicine and Gillings School of Global Public Health, Chapel Hill, North Carolina.Search for more papers by this author, Kristen Hassmiller Lich, MHA, PhDFrom University of North Carolina School of Medicine and Gillings School of Global Public Health, Chapel Hill, North Carolina.Search for more papers by this author, and A. Sidney Barritt IV, MD, MSCRFrom University of North Carolina School of Medicine and Gillings School of Global Public Health, Chapel Hill, North Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5049 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:As Kansagara and colleagues (1) suggest, a clinical trial would be the most definitive way to establish the effectiveness of hepatocellular carcinoma (HCC) screening. However, this method has multiple barriers, including cost, ethical concerns, and the enduring effect of such a trial in the face of new therapies for viral hepatitis. The use of simulation models to predict risk, cost-effectiveness, and outcomes has become increasingly common in the medical literature (2, 3).Modeling techniques, such as discrete event and individual-based simulation, can incorporate individual patient-level heterogeneity for underlying risk factors and tumor characteristics. Simulation models can account ...References1. Kansagara D, Papak J, Pasha AS, O'Neil M, Freeman M, Relevo R, et al. Screening for hepatocellular carcinoma in chronic liver disease: a systematic review. Ann Intern Med. 2014;161:261-9. [PMID: 24934699] doi:10.7326/M14-0558 LinkGoogle Scholar2. Brennan A, Chick SE, Davies R. A taxonomy of model structures for economic evaluation of health technologies. Health Econ. 2006;15:1295-310. [PMID: 16941543] CrossrefMedlineGoogle Scholar3. Morrissey JP, Lich KH, Price RA, Mandelblatt J. Computational modeling and multilevel cancer control interventions. J Natl Cancer Inst Monogr. 2012;2012:56-66. [PMID: 22623597] doi:10.1093/jncimonographs/lgs014 CrossrefMedlineGoogle Scholar4. Vanni T, Karnon J, Madan J, White RG, Edmunds WJ, Foss AM, et al. Calibrating models in economic evaluation: a seven-step approach. Pharmacoeconomics. 2011;29:35-49. [PMID: 21142277] doi:10.2165/11584600-000000000-00000 CrossrefMedlineGoogle Scholar5. Chilcott J, Brennan A, Booth A, Karnon J, Tappenden P. The role of modelling in prioritising and planning clinical trials. Health Technol Assess. 2003;7:1-125. [PMID: 14499052] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of North Carolina School of Medicine and Gillings School of Global Public Health, Chapel Hill, North Carolina.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0525. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Hepatocellular Carcinoma in Chronic Liver Disease Devan Kansagara , Joel Papak , Amirala S. Pasha , Maya O’Neil , Michele Freeman , Rose Relevo , Ana Quiñones , Makalapua Motu’apuaka , and Janice H. Jou Screening for Hepatocellular Carcinoma in Chronic Liver Disease Devan Kansagara , Joel Papak , Amirala S. Pasha , Maya O’Neil , Michele Freeman , Rose Relevo , Ana Quiñones , Makalapua Motu’apuaka , and Janice H. Jou Screening for Hepatocellular Carcinoma in Chronic Liver Disease Edoardo G. Giannini and Franco Trevisani Screening for Hepatocellular Carcinoma in Chronic Liver Disease Devan Kansagara , Joel Papak , and Janice H. Jou Screening for Hepatocellular Carcinoma in Chronic Liver Disease Devan Kansagara , Joel Papak , and Janice H. Jou Screening for Hepatocellular Carcinoma in Chronic Liver Disease Edoardo G. Giannini and Franco Trevisani Metrics Cited byDuration and cost-effectiveness of hepatocellular carcinoma surveillance in hepatitis C patients after viral eradicationChanging Epidemiology of Hepatocellular Carcinoma and Role of SurveillanceRole of long non-coding RNA in tumor drug resistance 3 February 2015Volume 162, Issue 3Page: 238-239KeywordsChronic liver diseaseClinical trialsDisclosureHepatitis AHepatocellular carcinomaMedical risk factorsObservational studiesSurvival analysis ePublished: 3 February 2015 Issue Published: 3 February 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...