Virtual Touch™ Quantification to Diagnose and Monitor Liver Fibrosis in Hepatitis B and Hepatitis C: A NICE Medical Technology Guidance.
Virtual Touch™ Quantification (VTq) is a software application used with Siemens Acuson ultrasound scanners to assess the stiffness of liver tissue. The National Institute for Health and Care Excellence (NICE) Medical Technologies Advisory Committee (MTAC) selected VTq for evaluation and invited the company to submit clinical and economic evidence. King's Technology Evaluation Centre, an External Assessment Centre (EAC) commissioned by NICE, independently assessed the evidence submitted. The EAC conducted its own systematic review, meta-analysis and economic analysis to supplement the company's submitted evidence. The meta-analyses comparing VTq and transient elastography (TE) with liver biopsy (LB) provided pooled estimates of liver stiffness and stage of fibrosis for the study populations (hepatitis B, hepatitis C or combined populations). When comparing significant fibrosis (Metavir score F ≥ 2) for both hepatitis B and C, VTq had slightly higher values for both sensitivity and specificity (77 and 81 %) than TE (76 and 71 %). The overall prevalence of cirrhosis (F4, combined populations) was similar with VTq and TE (23 vs. 23 %), and significant fibrosis (F ≥ 2) was lower for VTq than for TE (55 vs. 62 %). The EAC revised the company's de novo cost model, which resulted in a cost saving of £53 (against TE) and £434 (against LB). Following public consultation, taking into account submitted comments, NICE Medical Technology Guidance MTG27 was published in September 2015. This recommended the adoption of the VTq software to diagnose and monitor liver fibrosis in patients with hepatitis B or hepatitis C.
King's Technology Evaluation Centre, London, UK. jennifer.a.summers@kcl.ac.uk.|Division of Health and Social Care Research, King's College London, 4th Floor Addison House, Guy's Campus, London, SE1 1UL, UK. jennifer.a.summers@kcl.ac.uk.
Jennifer A
JA
Summers
King's Technology Evaluation Centre, London, UK.|King's Health Economics, King's College London, Institute of Psychiatry, The David Goldberg Centre, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
Muralikrishnan
M
Radhakrishnan
King's Technology Evaluation Centre, London, UK.|Division of Imaging Sciences and Biomedical Engineering King's College London, Department of Biomedical Engineering, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Elizabeth
E
Morris
King's Technology Evaluation Centre, London, UK.|Division of Imaging Sciences and Biomedical Engineering King's College London, Department of Biomedical Engineering, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Anastasia
A
Chalkidou
Division of Imaging Sciences and Biomedical Engineering King's College London, Department of Biomedical Engineering, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Tiago
T
Rua
Centre for Primary Care and Public Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
Anita
A
Patel
King's Technology Evaluation Centre, London, UK.|Division of Imaging Sciences and Biomedical Engineering King's College London, Department of Biomedical Engineering, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Viktoria
V
McMillan
Division of Health and Social Care Research, King's College London, 4th Floor Addison House, Guy's Campus, London, SE1 1UL, UK.
Abdel
A
Douiri
Division of Health and Social Care Research, King's College London, 4th Floor Addison House, Guy's Campus, London, SE1 1UL, UK.
Yanzhong
Y
Wang
Division of Health and Social Care Research, King's College London, 4th Floor Addison House, Guy's Campus, London, SE1 1UL, UK.
Salma
S
Ayis
Medical Technology Evaluation Programme, National Institute for Health and Care Excellence, Level 1A, City Tower, Piccadilly Plaza, Manchester, M1 4BT, UK.
Joanne
J
Higgins
King's Technology Evaluation Centre, London, UK.|Division of Imaging Sciences and Biomedical Engineering King's College London, Department of Biomedical Engineering, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.|Department of Medical Physics, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Stephen
S
Keevil
King's Technology Evaluation Centre, London, UK.|Department of Medical Engineering and Physics, King's College Hospital, London, SE5 9RS, UK.
Cornelius
C
Lewis
King's Technology Evaluation Centre, London, UK.|Division of Health and Social Care Research, King's College London, 4th Floor Addison House, Guy's Campus, London, SE1 1UL, UK.|NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, 7th Floor Capital House, 42 Weston Street, London, SE1 3QD, UK.
Janet
J
Peacock
D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D012680:Sensitivity and Specificity; D012984:Software; D013222:State Medicine / Q000592:standards; D013673:Technology Assessment, Biomedical; D016896:Treatment Outcome; D006113:United Kingdom