Appendix Figure 1. Screening for Hepatitis C: Analytic Framework

[D] Select for Text Description.

* Excluding pregnant women, HIV positive persons, transplant recipients, and patients with renal failure.

KQ 1: Does screening for hepatitis C reduce the risk or rates of harm and premature death and disability?
KQ 2: Can clinical or demographic characteristics identify a subgroup of asymptomatic patients at higher risk for HCV infection?
KQ 3: What are the test characteristics of HCV antibody testing?
KQ 4: What is the predictive value of a positive screening test result, and what are the harms associated with screening for HCV infection?
KQ 5: a) What are the test characteristics of the work-up for active disease?
          b) In patients found to be positive for hepatitis C virus antibody, what proportion of patients would qualify for treatment?
KQ 6: What are the harms associated with the work-up for active HCV disease?
KQ 7: a) How well does antiviral treatment reduce the rate of viremia, improve aminotransferase levels, and improve histology?
          b) How well does antiviral treatment improve health outcomes in asymptomatic patients with hepatitis C?
          c) How well do counseling and immunizations in asymptomatic patients with HCV infection improve clinical outcomes or prevent spread of disease?
KQ 8: What are the harms (including intolerance to treatment) associated with antiviral intervention?
KQ 9: Have improvements in intermediate outcomes (liver function tests, remission, histologic changes) been shown to reduce the risk or rate of harm from HCV infection?

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