title: Validating a Markov model of treatment for hepatitis C virus-related hepatocellular carcinoma.
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.
  
  
  METHODS
  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.
authors.affiliation: Medical of Medical Informatics and Decision Sciences, Yamaguchi University, Yamaguchi, Japan. hishida@yamaguchi-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Ishida
authors.forename: J B
authors.initials: JB
authors.lastname: Wong
authors.forename: K
authors.initials: K
authors.lastname: Hino
authors.forename: F
authors.initials: F
authors.lastname: Kurokawa
authors.forename: S
authors.initials: S
authors.lastname: Nishina
authors.forename: I
authors.initials: I
authors.lastname: Sakaida
authors.forename: K
authors.initials: K
authors.lastname: Okita
authors.forename: T
authors.initials: T
authors.lastname: Tamesa
authors.forename: M
authors.initials: M
authors.lastname: Oka
authors.forename: T
authors.initials: T
authors.lastname: Torimura
authors.forename: M
authors.initials: M
authors.lastname: Sata
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.forename: K
authors.initials: K
authors.lastname: Chayama
authors.forename: Y
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000191:economics / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D015233:Models, Statistical; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D013534:Survival