Validating a Markov model of treatment for hepatitis C virus-related hepatocellular carcinoma

Methods Inf Med. 2008;47(6):529-40. doi: 10.3414/ME9124. Epub 2008 Nov 20.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / economics
  • Carcinoma, Hepatocellular / etiology
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / physiopathology
  • Confidence Intervals
  • Cost-Benefit Analysis
  • Disease Progression
  • Female
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Hepatitis C / economics
  • Hepatitis C / mortality
  • Humans
  • Male
  • Markov Chains
  • Middle Aged
  • Models, Statistical
  • Probability
  • Prognosis
  • Retrospective Studies
  • Survival