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Methods Inf Med 2008; 47(06): 529-540
DOI: 10.3414/ME9124
Original Article
Schattauer GmbH

Validating a Markov Model of Treatment for Hepatitis C Virus-related Hepatocellular Carcinoma

H. Ishida
1   Department of Medical Informatics and Decision Sciences, Yamaguchi University Hospital, Yamaguchi, Japan
,
J.B. Wong
2   Department of Internal Medicine, New England Medical Center, Tufts University, Medford, MA, USA
,
K. Hino
3   Department of Internal Medicine, Kawasaki Medical School, Kurashiki, Japan
,
F. Kurokawa
4   Department of Internal Medicine, Yamaguchi Rosai Hospital, Yamaguchi, Japan
,
S. Nishina
5   Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
,
I. Sakaida
5   Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
,
K. Okita
6   Department of Internal Medicine, Shimonoseki Kousei Hospital, Jamaguchi, Japan
,
T. Tamesa
7   Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
,
M. Oka
7   Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
,
T. Torimura
8   Department of Digestive Disease Information and Research, Kurume University School of Medicine, Kurume, Japan
,
M. Sata
8   Department of Digestive Disease Information and Research, Kurume University School of Medicine, Kurume, Japan
,
S. Takahash
9   Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan
,
K. Chayama
9   Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan
,
Y. Inoue
1   Department of Medical Informatics and Decision Sciences, Yamaguchi University Hospital, Yamaguchi, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
18 January 2018 (online)

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Summary

Objective: We created and validated a Markov model to simulate the prognosis with treatment for HCV-related hepatocellular carcinoma (HCC) for assessment of cost-effectiveness for alternative treatments of HCC.

Method: Markov state incorporated into the model consisted of the treatment as a surrogate for HCC stage and underlying liver function. Retrospective data of 793 patients from three university hospitals were used to determine Kaplan-Meier survival curves for each treatment and transition probabilities were derived from them.

Results: There was substantial overlap in the 95% CIs of the Markov model predicted and the Kaplan-Meier survival curves for each therapy. The predicted survival curves were also similar with those from the nationwide survey data supporting the external validity of our model.

Conclusions: Our Markov model estimates for prognosis with HCC have both internal and external validity and should be considered applicable for estimating cost-effectiveness related to HCC.

Keywords

Hepatocellular carcinoma - prognosis - survival rate - Markov model - validation
 

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