Model for end-stage liver disease (MELD) and allocation of donor livers.

Background & Aims: A consensus has been reached that liver donor allocation should be based primarily on liver disease severity and that waiting time should not be a major determining factor. Our aim was to assess the capability of the Model for End-Stage Liver Disease (MELD) score to correctly rank potential liver recipients according to their severity of liver disease and mortality risk on the OPTN liver waiting list.

Methods: The MELD model predicts liver disease severity based on serum creatinine, serum total bilirubin, and INR and has been shown to be useful in predicting mortality in patients with compensated and decompensated cirrhosis.

Global epidemiology and burden of hepatitis C.

Despite rapid progress in our knowledge of hepatitis C virology and pathogenesis, little is known about the current and future burden of this infection throughout the world. Prevalence and population-based studies have suggested that complications of the liver disease associated with chronic hepatitis C infection may potentially require substantial health care resources and generate very high costs for medical systems in the United States, Europe and worldwide. Careful understanding and assessment of hepatitis C health and economic burdens are likely to guide better programs for the management of infected individuals and the prevention of complications.

Motion - the available treatments for hepatitis C are cost effective: arguments against the motion.

Hepatitis C is a prevalent infection in North America. However, the natural history of hepatitis C virus (HCV) infection in the general population is not fully understood. Available cohort-based studies suggest that only a relative minority of patients develop significant liver disease, such as cirrhosis and/or hepatocellular carcinoma.

The burden of hepatitis C in the United States.

According to the third National Health and Nutrition Examination Survey (NHANES), 3.9 million of the U.S.

Medical and economic impact of autoimmune hepatitis.

AIH is a chronic liver disease that has been associated with hepatic failure and death in the absence of liver transplantation. As a result, AIH imparts significant medical and economic burdens on affected patients and health care delivery systems, respectively. The use of accepted methodologies for outcomes and health services research has identified emerging information on the epidemiology and natural history, HRQoL, and resource utilization for similar autoimmune chronic liver diseases such as PBC and PSC.

Bayesian estimation, simulation and uncertainty analysis: the cost-effectiveness of ganciclovir prophylaxis in liver transplantation.

This paper demonstrates the usefulness of combining simulation with Bayesian estimation methods in analysis of cost-effectiveness data collected alongside a clinical trial. Specifically, we use Markov Chain Monte Carlo (MCMC) to estimate a system of generalized linear models relating costs and outcomes to a disease process affected by treatment under alternative therapies. The MCMC draws are used as parameters in simulations which yield inference about the relative cost-effectiveness of the novel therapy under a variety of scenarios.

Diagnosis and 10-year follow-up of a community-based hepatitis C cohort.

Objective: To determine the health care follow-up and treatment associated with physician-diagnosed hepatitis C (HCV) in a community-based population.

Study Design: We conducted a retrospective medical record review using records from all providers in Olmsted County, Minnesota.

Population: The study incorporated all Olmsted County residents with physician-diagnosed hepatitis C from 1990 through 1999.

Development and maintenance of a community-based hepatitis C registry.

Objective: To develop a model for community-population- or health system-based registries of all patients with diagnosed hepatitis C, to facilitate clinical care and epidemiologic studies.

Study Design: Geographically defined, population-based cohort study.

Methods: Registry subjects were identified using January 1, 1990, to December 31, 1999, data from the Rochester Epidemiology Project (REP), which lists all diagnoses for Olmsted County residents recorded by clinicians during visits to Olmsted County medical providers.