{"id":14233,"date":"2019-12-30T09:34:30","date_gmt":"2019-12-30T08:34:30","guid":{"rendered":"https:\/\/asscat-hepatitis.org\/?p=14233"},"modified":"2019-12-30T09:34:30","modified_gmt":"2019-12-30T08:34:30","slug":"rendibilitat-de-lelastografia-transitoria-per-a-la-deteccio-de-la-fibrosi-hepatica","status":"publish","type":"post","link":"https:\/\/asscat-hepatitis.org\/ca\/rendibilitat-de-lelastografia-transitoria-per-a-la-deteccio-de-la-fibrosi-hepatica\/","title":{"rendered":"Rendibilitat de l\u2019elastografia transit\u00f2ria per a la detecci\u00f3 de la fibrosi hep\u00e0tica"},"content":{"rendered":"<p>[et_pb_section bb_built=&#8221;1&#8243; disabled_on=&#8221;off|off|off&#8221; _builder_version=&#8221;3.0.106&#8243; custom_margin=&#8221;|||&#8221; custom_padding=&#8221;0px||0px|&#8221; next_background_color=&#8221;#000000&#8243;][et_pb_row custom_padding=&#8221;0px||0px|&#8221; _builder_version=&#8221;3.0.106&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_post_title author=&#8221;off&#8221; date_format=&#8221;d\/m\/Y&#8221; comments=&#8221;off&#8221; featured_placement=&#8221;background&#8221; text_background=&#8221;on&#8221; text_bg_color=&#8221;#ffffff&#8221; module_class=&#8221;ac-post-title-section-0&#8243; _builder_version=&#8221;3.0.106&#8243; title_font=&#8221;Montserrat|600|||||||&#8221; title_text_color=&#8221;#2d2d2d&#8221; title_letter_spacing=&#8221;-1px&#8221; title_line_height=&#8221;1.2em&#8221; meta_font=&#8221;Open Sans||||||||&#8221; meta_text_color=&#8221;rgba(45,45,45,0.5)&#8221; text_orientation=&#8221;center&#8221; custom_margin=&#8221;|||&#8221; custom_padding=&#8221;|20px|20px|20px&#8221; title_text_align=&#8221;center&#8221; meta_font_size=&#8221;13px&#8221; meta_text_align=&#8221;center&#8221;]<\/p>\n<p>&nbsp;<\/p>\n<p>[\/et_pb_post_title][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section bb_built=&#8221;1&#8243; specialty=&#8221;on&#8221; _builder_version=&#8221;3.0.106&#8243; custom_padding=&#8221;0px|||&#8221; prev_background_color=&#8221;#000000&#8243; next_background_color=&#8221;#000000&#8243;][et_pb_column type=&#8221;2_3&#8243; specialty_columns=&#8221;2&#8243;][et_pb_row_inner admin_label=&#8221;Fila&#8221; _builder_version=&#8221;3.0.106&#8243;][et_pb_column_inner type=&#8221;4_4&#8243; saved_specialty_column_type=&#8221;2_3&#8243;][et_pb_text admin_label=&#8221;Contenido Entrada 1&#8243; ul_type=&#8221;square&#8221; module_class=&#8221;ac-posts-content&#8221; _builder_version=&#8221;3.0.106&#8243; text_orientation=&#8221;justified&#8221; background_layout=&#8221;light&#8221;]<\/p>\n<h3>En aquest estudi s\u2019avalua la rendibilitat de l\u2019elastografia transit\u00f2ria per a la detecci\u00f3 de fibrosi hep\u00e0tica en pacients amb malaltia hep\u00e0tica relacionada amb l\u2019alcohol i sense alcohol en un entorn d\u2019atenci\u00f3 prim\u00e0ria. En total, es van analitzar 6 cohorts prospectives amb m\u00e9s de 6.000 pacients.<\/h3>\n<p>Els resultats van demostrar que l\u2019\u00fas de l\u2019elastografia transit\u00f2ria pot estalviar costos en un entorn d\u2019atenci\u00f3 prim\u00e0ria, ja que condueix a una identificaci\u00f3 m\u00e9s preco\u00e7 dels pacients que requereixen atenci\u00f3 de subespecialitat. Un punt de tall de 9,1 kPa semblava ser el m\u00e9s efectiu per identificar pacients amb almenys fibrosi F2.<\/p>\n<h3>Context i objectius<\/h3>\n<p>La malaltia del fetge gras no alcoh\u00f2lic i la malaltia del fetge relacionada amb l\u2019alcohol representen un repte important per a les vies cl\u00edniques d\u2019atenci\u00f3 m\u00e8dica actuals degut a la gran quantitat de pacients en risc. Per tant, el nostre objectiu va ser explorar la rendibilitat de l\u2019elastografia transit\u00f2ria (ET) com a m\u00e8tode de detecci\u00f3 per detectar la fibrosi hep\u00e0tica en una via d\u2019atenci\u00f3 prim\u00e0ria.<\/p>\n<h3>M\u00e8todes<\/h3>\n<p>L\u2019an\u00e0lisi de cost-efectivitat es va realitzar emprant dades de pacients individuals de la vida real de 6 cohorts prospectives independents (5 d\u2019Europa i 1 d\u2019\u00c0sia). Es va desenvolupar un algoritme de diagn\u00f2stic amb arbres d\u2019infer\u00e8ncia condicional per explorar les relacions entre rigidesa hep\u00e0tica, socio-demografia, comorbiditats i fibrosi hep\u00e0tica, aquesta \u00faltima avaluada per puntuacions de fibrosi (FIB-4, NFS) i bi\u00f2psies hep\u00e0tiques en un subconjunt de 352 pacients. Vam comparar la relaci\u00f3 cost-efectivitat incremental d\u2019una estrat\u00e8gia de detecci\u00f3 amb l\u2019est\u00e0ndard d\u2019atenci\u00f3 juntament amb els n\u00fameros necessaris per a la detecci\u00f3 per diagnosticar a un pacient amb fibrosi en etapa \u2265F2.<\/p>\n<h3>Resultats<\/h3>\n<p>El conjunt de dades va abastar a 6.295 participants (edat mitjana 55 \u00b1 12 anys, IMC 27 \u00b1 5 kg \/ m<sup>2<\/sup>, rigidesa hep\u00e0tica 5,6 \u00b1 5,0 kPa). Un l\u00edmit de 9,1kPa d\u2019ET va proporcionar la millor precisi\u00f3 pel diagn\u00f2stic de fibrosi significativa (\u2265F2) en entorns de poblaci\u00f3 general, mentre que un llindar de 9,5kPa va ser \u00f2ptim per a les poblacions en risc de malaltia hep\u00e0tica relacionada amb l\u2019alcohol. L\u2019ET amb els punts de tall proposats va superar les puntuacions de fibrosi en termes de precisi\u00f3. El cribratge amb ET va ser rendible amb una relaci\u00f3 cost-efectiva incremental mitjana que oscil\u00b7la entre 2.570 \u20ac \/ AVAC (IC 95% 2,456-2,683) per a una poblaci\u00f3 en risc de malaltia hep\u00e0tica relacionada amb l\u2019alcohol (edat \u226545 anys) a 6.217 \u20ac \/ AVAC (IC 95% 5,832-6,601) en la poblaci\u00f3 general. En general, va haver-hi un 12% de possibilitats que la detecci\u00f3 de l\u2019ET estalviar\u00e0 costos en tots els pa\u00efsos i poblacions.<\/p>\n<h3>Conclusions<\/h3>\n<p>La detecci\u00f3 de fibrosi hep\u00e0tica amb ET en l\u2019atenci\u00f3 prim\u00e0ria \u00e9s una intervenci\u00f3 rendible per a les poblacions europees i asi\u00e0tiques i fins i tot pot estalviar costos.<\/p>\n<h3>Resum final<\/h3>\n<p>La manca d\u2019estrat\u00e8gies de detecci\u00f3 de salut p\u00fablica optimitzades per a la detecci\u00f3 de fibrosi hep\u00e0tica en adults sense malaltia hep\u00e0tica coneguda presenta un important repte d\u2019atenci\u00f3 m\u00e8dica. Les an\u00e0lisis de 6 cohorts internacionals independents, amb mesuraments d\u2019elastografia transit\u00f2ria, mostren que una estrat\u00e8gia d\u2019estratificaci\u00f3 de risc basada en la comunitat per a les malalties del fetge gras relacionades amb l\u2019alcohol i no alcoh\u00f2liques \u00e9s rendible i potencialment estalvia costos pels nostres sistemes de salut, ja que condueix a una identificaci\u00f3 preco\u00e7 de pacients.<\/p>\n<p>&nbsp;<\/p>\n<p>Font: <a href=\"https:\/\/www.journal-of-hepatology.eu\/article\/S0168-8278(19)30486-6\/fulltext\">journal-of-hepatology.eu<\/a><\/p>\n<p>Refer\u00e8ncia: J. Hepatol. 2019 Dec 01;71(6)1141-1151, M Serra-Burriel, I Graupera, P Tor\u00e1n, M Thiele, D Roulot, V Wai-Sun Wong, I Neil Guha, N Fabrellas, A Arslanow, C Exp\u00f3sito, R Hern\u00e1ndez, G Lai-Hung Wong, D Harman, S Darwish Murad, A Krag, G Pera, P Angeli, P Galle, GP Aithal, L Caballeria, L Castera, P Gin\u00e8s, F Lammert. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.1016\/j.jhep.2019.08.019\">https:\/\/doi.org\/10.1016\/j.jhep.2019.08.019<\/a><\/p>\n<p>Article tradu\u00eft per l\u2019ASSCAT<\/p>\n<p>[\/et_pb_text][\/et_pb_column_inner][\/et_pb_row_inner][et_pb_row_inner admin_label=&#8221;Fila&#8221; custom_padding=&#8221;0px|||&#8221; _builder_version=&#8221;3.0.105&#8243; custom_margin=&#8221;|||&#8221;][et_pb_column_inner type=&#8221;4_4&#8243; saved_specialty_column_type=&#8221;2_3&#8243;][et_pb_post_title admin_label=&#8221;Metadatos &#8211; Fecha \u00daltima actualizaci\u00f3n&#8221; title=&#8221;off&#8221; author=&#8221;off&#8221; date_format=&#8221;d\/m\/Y&#8221; categories=&#8221;off&#8221; comments=&#8221;off&#8221; featured_image=&#8221;off&#8221; _builder_version=&#8221;3.0.106&#8243; title_text_align=&#8221;left&#8221; meta_font=&#8221;Open Sans||||||||&#8221; meta_text_align=&#8221;left&#8221; meta_font_size=&#8221;13px&#8221; meta_text_color=&#8221;#0082ca&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#cccccc&#8221; custom_margin=&#8221;50px|||&#8221; custom_padding=&#8221;10px|||&#8221; custom_css_before=&#8221;content:%22\u00daltima actualizaci\u00f3n:%22;&#8221; global_module=&#8221;3449&#8243; saved_tabs=&#8221;all&#8221;]<\/p>\n<p>&nbsp;<\/p>\n<p>[\/et_pb_post_title][\/et_pb_column_inner][\/et_pb_row_inner][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243;][et_pb_sidebar orientation=&#8221;right&#8221; area=&#8221;et_pb_widget_area_8&#8243; module_class=&#8221;ac-posts-sidebar&#8221; _builder_version=&#8221;3.0.106&#8243; global_module=&#8221;3198&#8243; saved_tabs=&#8221;all&#8221;]<\/p>\n<p>&nbsp;<\/p>\n<p>[\/et_pb_sidebar][\/et_pb_column][\/et_pb_section][et_pb_section bb_built=&#8221;1&#8243; _builder_version=&#8221;3.0.106&#8243; custom_padding=&#8221;||0px|&#8221; prev_background_color=&#8221;#000000&#8243; module_class=&#8221;ac-post-section-share-rrss&#8221;][et_pb_row custom_padding=&#8221;||0px|&#8221; custom_margin=&#8221;|||&#8221; _builder_version=&#8221;3.0.105&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_divider color=&#8221;#e20611&#8243; show_divider=&#8221;on&#8221; divider_style=&#8221;ridge&#8221; _builder_version=&#8221;3.0.106&#8243; \/][et_pb_text _builder_version=&#8221;3.0.106&#8243; text_font=&#8221;Montserrat||||||||&#8221; text_text_color=&#8221;#e20611&#8243; text_orientation=&#8221;center&#8221; custom_margin=&#8221;||0px|&#8221; custom_padding=&#8221;|||&#8221; background_layout=&#8221;light&#8221; disabled=&#8221;on&#8221;]<\/p>\n<h5>Desde aqu\u00ed puedes compartir esta publicaci\u00f3n. \u00a1Gracias!<\/h5>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n<!-- Begin Yuzo --><div class='yuzo_related_post style-1'  data-version='5.12.77'><!-- without result --><div class='yuzo_clearfixed yuzo__title yuzo__title'><h3>Related Post<\/h3><\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/asscat-hepatitis.org\/ca\/nova-alternativa-terapeutica-pel-vhc-g3-amb-cirrosi-compensada\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/asscat-hepatitis.org\/wp-content\/uploads\/maria-buti-1-150x150.png') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Nova alternativa terap\u00e8utica pel VHC G3 amb cirros...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/asscat-hepatitis.org\/ca\/egipte-tracta-a-mes-de-400-000-infectats-per-lhepatitis-c\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/asscat-hepatitis.org\/wp-content\/uploads\/egipto-150x150.jpg') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Egipte tracta a m\u00e9s de 400.000 infectats per l\u2019hep...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/asscat-hepatitis.org\/ca\/investigadors-senyalen-una-molecula-com-un-prometedor-agent-terapeutic-contra-el-fetge-gras\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/asscat-hepatitis.org\/wp-content\/uploads\/higado-graso-25-150x150.jpg') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Investigadors senyalen una mol\u00e8cula com un \u201cpromet...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/asscat-hepatitis.org\/ca\/digestiu-de-lleo-presenta-a-sacyl-un-projecte-per-diagnosticar-lhepatitis-c\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/asscat-hepatitis.org\/wp-content\/uploads\/sacyl-150x139.png') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Digestiu de Lle\u00f3 presenta a Sacyl un projecte per ...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n<\/div> <style>\n\t\t\t\t\t\t\t\t.yuzo_related_post img{width:120px !important; height:110px !important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb{line-height:15px;background: !important;color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb:hover{background:#fcfcf4 !important; -webkit-transition: background 0.2s linear; -moz-transition: background 0.2s linear; -o-transition: background 0.2s linear; transition: background 0.2s linear;;color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb a{color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb a:hover{ color:}!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb:hover a{ color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .yuzo_text {color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb:hover .yuzo_text {color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb{  margin: 0px  0px  0px  0px;   padding: 5px  5px  5px  5px;  }\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/style> <script>\n\t\t\t\t\t\t  jQuery(document).ready(function( $ ){\n\t\t\t\t\t\t\t\/\/jQuery('.yuzo_related_post').equalizer({ overflow : 'relatedthumb' });\n\t\t\t\t\t\t\tjQuery('.yuzo_related_post .yuzo_wraps').equalizer({ columns : '> div' });\n\t\t\t\t\t\t   })\n\t\t\t\t\t\t  <\/script> <!-- End Yuzo :) -->","protected":false},"excerpt":{"rendered":"<p>L\u2019\u00fas de l\u2019elastografia transit\u00f2ria pot estalviar costos en un entorn d\u2019atenci\u00f3 prim\u00e0ria, ja que condueix a una identificaci\u00f3 m\u00e9s preco\u00e7 dels pacients que requereixen atenci\u00f3 de subespecialitat.<\/p>\n","protected":false},"author":9,"featured_media":14235,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","footnotes":""},"categories":[567,568],"tags":[4128,1125,1086,850,5166,4035,1163],"class_list":["post-14233","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articulos-ca","category-articulos-cientificos-ca","tag-articles-cientifics-ca","tag-atencio-primaria","tag-deteccio-precoc","tag-elastografia-transitoria-ca","tag-estalvi-de-costos","tag-estudi-ca","tag-fibrosi-hepatica"],"_links":{"self":[{"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/posts\/14233","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/comments?post=14233"}],"version-history":[{"count":0,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/posts\/14233\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/media\/14235"}],"wp:attachment":[{"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/media?parent=14233"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/categories?post=14233"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/tags?post=14233"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}