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2 Screening Studies
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AASLD: Hepatitis C Screening & Prevalence among Veterans in Dept of Veterans Affairs Care in 2012 - (11/18/13)
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"Hepatitis C Virus (HCV) Antibody Positivity and Predictors among Adult Primary Care Patients: Cross-Sectional Analysis of a Multi-Site Retrospective Cohort Study"
Anthony K. Yartel2, David B. Rein7, Katherine Krauskopf4, Omar I. Massoud5, Kimberly Ann Brown3, Michael B. Fallon6, Bryce D. Smith1
Institutional Author(s):
INSTITUTIONS (ALL): 1.Centers for Disease Control and Prevention, Atlanta, GA, United States.
2. Centers for Disease Control and Prevention Foundation, Atlanta, GA, United States.
3. Henry Ford Hospital, Detroit, MI, United States.
4. Mount Sinai School of Medicine, New York, NY, United States.
5. University of Alabama at Birmingham, Birmingham, AL, United States.
6. University of Texas Health Science Center at Houston, Houston, TX, United States.
7. NORC at the University of Chicago, Atlanta, GA, United States.
These data suggest that 81% of the total HCV cases (identified and estimated) in this primary care setting were not identified using risk-based screening
The purpose of this study was to determine the prevalence and predictors of anti-HCV positivity among a geographically and demographically diverse population, and to estimate the proportion of anti-HCV+ persons who may have been unidentified using risk-based screening.
METHODS: We analyzed electronic medical record data from a four-site retrospective study. Patients were aged ≥18 years, utilized ≥1 primary care outpatient service(s) between 2005 and 2010, and had no documented evidence of prior HCV diagnosis. Among those tested for anti-HCV, we fit a multilevel logistic regression model to identify patient-level independent predictors of anti-HCV positivity. Predictors included birth year, sex, race/ethnicity, marital status, alanine aminotransferase (ALT) levels, ever injecting drugs (ever IDU), hemophilia, HIV infection, and number of visits. We estimated unidentified anti-HCV cases by using multiple imputation to assign anti-HCV results to patients who were not tested, conditional on other observed data.
We estimated that if all 209,076 patients had been tested, a total of 6,005 anti-HCV+ cases (i.e. 2.9% overall predicted prevalence) would have been identified. Relative to the actual number of anti-HCV+ cases identified (n=1,115) by testing, an estimated 81% (4,890/6,005) of anti-HCV+ patients were unidentified.
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