Telephone-Only Visits Preserved Hepatocellular Cancer Screening Rates in Patients with Cirrhosis Early in the COVID-19 Pandemic

Rudnick, Seth A.; Ugwuegbu, Judy; Soufleris, Stephen James; Bundy, Richa; Dharod, Ajay; Russo, Mark W.

doi:10.1007/s10620-022-07786-0

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…[3] Telemedicine has also been shown to increase rates of adequate HCC screening and extend the reach of a relatively small number of specialty providers to patients whose need for screening may otherwise go unrecognized. [9] Personalized medicine will also improve HCC screening; with several risk calculators available, providers can better identify patients who are at the highest risk of HCC and focus outreach efforts on this population. [10] In addition to increasing access to regular screening, several promising changes to screening testing to improve sensitivity and specificity are under development.…”

Section: Effective Interventions For Gaps In Screeningmentioning

confidence: 99%

“…Automated letters, phone calls, and reviews of quality dashboards on a population level are all impactful 3 . Telemedicine has also been shown to increase rates of adequate HCC screening and extend the reach of a relatively small number of specialty providers to patients whose need for screening may otherwise go unrecognized 9 . Personalized medicine will also improve HCC screening; with several risk calculators available, providers can better identify patients who are at the highest risk of HCC and focus outreach efforts on this population 10 …”

Section: Introductionmentioning

confidence: 99%

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Improving access to screening and treatment of hepatocellular carcinoma in the United States

Davis,

Rabiee

2024

Clinical Liver Disease

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Section: Effective Interventions For Gaps In Screeningmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving access to screening and treatment of hepatocellular carcinoma in the United States

Davis,

Rabiee

2024

Clinical Liver Disease

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Decreased Completion of Ordered Laboratories and Imaging in Telehealth Compared With In-person Hepatology Encounters

Henson,

Patel,

Wall

et al. 2024

Journal of Clinical Gastroenterology

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Objective: To evaluate order completion after telehealth compared with in-person encounters. Background: Completion of ordered testing, including laboratories and imaging, is an important aspect of successful outpatient care of patients with liver disease. Whether the completion of orders from telehealth encounters differs from in-person visits is unknown. Materials and Methods: Completion of ordered laboratories and imaging from hepatology encounters at our center from 2021 to 2022 were evaluated and compared between video telehealth and in-person visits. Laboratory completion was evaluated at 14 days, 30 days, and 90 days, and imaging completion was assessed at 1 year. Results: Telehealth encounters were significantly less likely to have laboratories completed at all evaluated time points (14 d: 40.7% vs 90.9%; 30 d: 50.9% vs 92.2%; 90 d: 63.9% vs 94.3%, P< 0.001 for all). Among telehealth encounters, encounters in patients more remote from the center were less likely to have laboratories completed. Imaging ordered at telehealth encounters was also less likely to be completed within 1 year (62.5% vs 70.1%, P< 0.001), including liver ultrasounds (59.1% vs 67.6%, P= 0.001), which persisted when limited to encounters for cirrhosis (55.8% vs 66.4%, P= 0.01). Conclusions: Telehealth encounters were significantly less likely to have ordered laboratories and imaging completed compared with in-person visits, which has important clinical implications for effective outpatient care of patients with liver disease. Further research is needed to better understand the barriers to order completion for telehealth visits and ways to optimize this to improve the effectiveness of this visit modality.

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Impact of COVID‐19 pandemic on hepatocellular carcinoma surveillance in British Columbia, Canada: An interrupted time series study

Makuza,

Wong,

Morrow

et al. 2024

Journal of Viral Hepatitis

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We assessed the impact of the COVID‐19 pandemic on hepatocellular carcinoma (HCC) surveillance among individuals with HCV diagnosed with cirrhosis in British Columbia (BC), Canada. We used data from the British Columbia Hepatitis Testers Cohort (BC‐HTC), including all individuals in the province tested for or diagnosed with HCV from 1 January 1990 to 31 December 2015, to assess HCC surveillance. To analyse the impact of the pandemic on HCC surveillance, we used pre‐policy (January 2018 to February 2020) and post‐policy (March to December 2020) periods. We conducted interrupted time series (ITS) analysis using a segmented linear regression model and included first‐order autocorrelation terms. From January 2018 to December 2020, 6546 HCC screenings were performed among 3429 individuals with HCV and cirrhosis. The ITS model showed an immediate decrease in HCC screenings in March and April 2020, with an overall level change of −71 screenings [95% confidence interval (CI): −105.9, −18.9]. We observed a significant decrease in HCC surveillance among study participants, regardless of HCV treatment status and age group, with the sharpest decrease among untreated HCV patients. A recovery of HCC surveillance followed this decline, reflected in an increasing trend of 7.8 screenings (95% CI: 0.6, 13.5) per month during the post‐policy period. There was no level or trend change in the number of individuals diagnosed with HCC. We observed a sharp decline in HCC surveillance among people living with HCV and cirrhosis in BC following the COVID‐19 pandemic control measures. HCC screening returned to pre‐pandemic levels by mid‐2020.

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Telephone-Only Visits Preserved Hepatocellular Cancer Screening Rates in Patients with Cirrhosis Early in the COVID-19 Pandemic

Cited by 4 publications

References 9 publications

Improving access to screening and treatment of hepatocellular carcinoma in the United States

Improving access to screening and treatment of hepatocellular carcinoma in the United States

Decreased Completion of Ordered Laboratories and Imaging in Telehealth Compared With In-person Hepatology Encounters

Impact of COVID‐19 pandemic on hepatocellular carcinoma surveillance in British Columbia, Canada: An interrupted time series study

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