| Title |
Hepatitis B virus screening before adjuvant chemotherapy in patients with early-stage breast cancer: a cost-effectiveness analysis
|
|---|---|
| Published in |
Breast Cancer Research and Treatment, May 2015
|
| DOI | 10.1007/s10549-015-3382-7 |
| Pubmed ID | |
| Authors |
William W. L. Wong, Lisa K. Hicks, Hong-Anh Tu, Kathleen I. Pritchard, Murray D. Krahn, Jordan J. Feld, Kelvin K. Chan |
| Abstract |
Most patients with hepatitis B virus (HBV) have no symptoms, and many are unaware of the infection. However, HBV can reactivate with immunosuppression; chemotherapy causes reactivation in 22 % of hepatitis B surface antigen-positive patients. HBV reactivation can be fatal. HBV reactivation can be prevented, provided that HBV is recognized prior to chemotherapy. The objective of this study is to estimate the health and economic effects of HBV screening strategies in patients receiving adjuvant chemotherapy for breast cancer. We developed a state-transition microsimulation model to examine the cost-effectiveness of three HBV screening strategies: (1) "No screening"; (2) "Screen-and-Treat to prevent reactivation" (screen-all) with either lamivudine/tenofovir (LAM/TDF) or entecavir (ETV); and (3) "Screen-and-Treat high-risk only" (screen-HR) and treat with either LAM/TDF or ETV. Model data were obtained from the published literature. We used a payer's perspective, a lifetime horizon, and a 5 % discount rate for the analysis. "Screen-all" would prevent at least 38 severe reactivations per 100,000 persons screened over the lifetime of the cohort. "Screen-all" was associated with an increase of 0.0034-0.0035 QALYs and an additional cost of C$164-C$266 per person, which translated into an incremental cost-effectiveness ratio of C$47,808/QALY-C$76,527/QALY gained compared with "No screening" depending on the antiviral therapy received. "Screen-all" was the most cost-effective strategy, while "Screen-HR" was inferior in all scenarios tested. HBV screening before adjuvant chemotherapy for breast cancer patients would prevent a significant number of reactivations, would likely be moderately cost-effective, and may extend the lives of breast cancer patients. |
X Demographics
The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 3 | 50% |
| Spain | 1 | 17% |
| El Salvador | 1 | 17% |
| Unknown | 1 | 17% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 83% |
| Scientists | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 56 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 2% |
| Unknown | 55 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 13 | 23% |
| Other | 5 | 9% |
| Student > Bachelor | 5 | 9% |
| Student > Ph. D. Student | 4 | 7% |
| Student > Master | 4 | 7% |
| Other | 9 | 16% |
| Unknown | 16 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 29% |
| Economics, Econometrics and Finance | 7 | 13% |
| Mathematics | 2 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 4% |
| Agricultural and Biological Sciences | 2 | 4% |
| Other | 7 | 13% |
| Unknown | 20 | 36% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 May 2015.
All research outputs
#6,733,972
of 22,803,211 outputs
Outputs from Breast Cancer Research and Treatment
#1,468
of 4,656 outputs
Outputs of similar age
#79,288
of 264,485 outputs
Outputs of similar age from Breast Cancer Research and Treatment
#20
of 72 outputs
Altmetric has tracked 22,803,211 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 4,656 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.2. This one has gotten more attention than average, scoring higher than 68% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,485 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 72 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.