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Kansagara D, Papak J, Pasha AS, et al. Screening for Hepatocellular Cancer in Chronic Liver Disease: A Systematic Review [Internet]. Washington (DC): Department of Veterans Affairs (US); 2014 Jan.
Screening for Hepatocellular Cancer in Chronic Liver Disease: A Systematic Review [Internet].
Show detailsCode | Definition | Exclusion criteria/notes | Screening studies inclusion criteria | Treatment studies inclusion criteria |
---|---|---|---|---|
I-Screening I-Treatment | Include – screening Include – treatment | KQ1 –Benefits of screening: 1a. In which subgroups of patients with chronic liver disease have the effects of HCC screening on patient survival been evaluated? 1b. What are the effects of HCC screening on disease-specific and all-cause mortality in these patient subgroups? 1c. Are there particular HCC screening modalities that are more effective on patient survival than others? KQ2 –Harms of screening: 2. What are the harms of HCC screening among patients with chronic liver disease? | KQ3 – What are the benefits and harms of treating early stage HCC? | |
I-SR | Include – systematic review | Systematic review or meta-analysis that addresses any of the key questions. Code X9-SR for comparative effectiveness reviews of treatment modalities. | ||
X1 | Non-English language | Most foreign language abstracts have been filtered out, but can be retrieved for further review as needed. | ||
X2 | Not relevant to HCC | |||
X3 | Study population is not in scope for either screening or treatment KQs. | Exclude: Patients with prior, advanced, or metastatic HCC; in vitro studies. | Adults with chronic active viral hepatitis, alcohol-related liver disease, non-alcoholic steatohepatitis, non-alcoholic fatty liver disease, hemochromatosis, primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune hepatitis – all with or without cirrhosis. | Patients with early stage HCC, defined as patients with the equivalent of BCLC Stage A (3 or fewer nodules, <3cm, or 1 nodule <5 cm). Milan criteria = early stage HCC. Include studies for which at least a portion of the population is Stage A and B (these studies may be useful for addressing harms). |
X4 | No primary data, or study design not in scope | Exclude: Non-systematic or narrative reviews, opinions, case studies, case series, quasi-experimental studies, or other excluded study designs. | Include studies that compare screened patients with unscreened patients, using any of the following study designs:
For cost studies: include primary data collected in U.S. settings. Exclude modeling and simulation studies, and primary studies in non-U.S. settings. | Included study designs:
Code X9 for head-to-head/active-controlled treatment trials; X9-SR for comparative effectiveness reviews; add combo (e.g. X9-combo) to indicate multiple treatment modalities. Use code X10 for observational studies include an untreated comparison group, and contain data on harms of treatment but sample size is <100 treated patients. |
X5 | Modality used for screening or treatment is not in scope | Excluded screening modalities: Biomarkers, thrombocytopenia, DNA/ RNA analyses. Excluded treatment modalities: Exclude percutaneous alcohol injection (no longer in use, and not in 2010 guidelines). Specify excluded treatments as they occur in the screening process. | Ultrasound, CT, MRI, and/or alpha-fetal protein screening for primary HCC. | Early stage/curative treatments include resection, transplant, radiofrequency ablation, transarterial chemoembolization, and sorafenib. |
X6 | None of the reported outcomes are in scope | Exclude studies that do not report any of the outcomes of interest. Exclude diagnostic accuracy studies. | Benefits:
| Benefits:
|
X7 | Other reason: specify | Add comments or keywords as needed. | ||
X9 | Exclude head-to-head/active-controlled treatment trials. Code X9-SR for systematic reviews/ meta-analyses on comparative effectiveness. X9-combo, where applicable. | |||
X10 | Exclude relevant observational studies on treatments with sample size <100 treated patients (we may pull these later if low yield of studies with n≥100). | |||
X11 | Duplicate publication | Exclude older publications or conference proceedings that have been subsequently published as full-text articles | ||
Note: Excluded articles should each receive a single X code, according to the order listed. Articles coded for background (‘B’) should also receive an X code. | ||||
B | Background | Add ‘B’ any of the above X codes (e.g., ‘X6–B’) if the article contains information that may be useful for the introduction, discussion, limitations, future research, or other contextual purposes. Add comments or keywords as needed. |
- INCLUSION/EXCLUSION CRITERIA - Screening for Hepatocellular Cancer in Chronic Li...INCLUSION/EXCLUSION CRITERIA - Screening for Hepatocellular Cancer in Chronic Liver Disease: A Systematic Review
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