Clinical outcome indicators in chronic hepatitis B and C: A primer for value‐based medicine in hepatology

• DOI: 10.1111/liv.14285
• Publication Date: 2019-10-26T15:33:48Z
• Authors: Mario Strazzabosco; Paolo A. Cortesi; Sara Conti; Stefano Okolicsanyi; Matteo Rota; Antonio Ciaccio; Paolo Cozzolino; Carla Fornari; Marta Gemma; Luciana Scalone; Giancarlo Cesana; Luca Fabris; Michele Colledan; Stefano Fagiuoli; Gaetano Ideo; Claudio Zavaglia; Giovanni Perricone; Luca M. Munari; Lorenzo G. Mantovani; Luca S. Belli
• Keywords: Clinical Practice; Delphi Method; Hepatitis C; Liver disease

Abstract Background & Aims Chronic liver diseases (CLDs) are major health problems that require complex and costly treatments. Liver‐specific clinical outcome indicators (COIs) able to assist both clinicians administrators in improving the value of care presently lacking. The Value‐Based Medicine Hepatology (VBMH) study aims fill this gap, devising testing a set COIs for CLD, could be easily collected during practice. Here we report generated recorded patients with HBV or HCV infection at different stages disease. Methods / Results In first phase VBMH study, were identified, based on current international guidelines literature, using modified Delphi method RAND 9‐point appropriateness scale. second phase, tested an observational, longitudinal, prospective, multicentre Lombardy, Italy. Eighteen identified patients. Patients CLD secondary (547) (1391) enrolled over 18‐month period followed median 4 years. estimation proposed was feasible real‐word practice COI values compared well literature data. Further, capture impact new effective treatments like direct‐acting antivirals (DAAs) Conclusions efficiently measured outcomes CLDs. While specific settings related healthcare systems may modify their implementation, these will represent important component tools value‐based approach hepatology positively affect delivery.