Virtual Touch™ Quantification to Diagnose and Monitor Liver Fibrosis in Hepatitis B and Hepatitis C: A NICE Medical Technology Guidance

Jennifer A. Summers (), Muralikrishnan Radhakrishnan, Elizabeth Morris, Anastasia Chalkidou, Tiago Rua, Anita Patel, Viktoria McMillan, Abdel Douiri, Yanzhong Wang, Salma Ayis, Joanne Higgins, Stephen Keevil, Cornelius Lewis and Janet Peacock
Additional contact information
Jennifer A. Summers: King’s Technology Evaluation Centre
Muralikrishnan Radhakrishnan: King’s Technology Evaluation Centre
Elizabeth Morris: King’s Technology Evaluation Centre
Anastasia Chalkidou: King’s Technology Evaluation Centre
Tiago Rua: St Thomas’ Hospital
Anita Patel: Queen Mary University of London
Viktoria McMillan: King’s Technology Evaluation Centre
Abdel Douiri: King’s College London
Yanzhong Wang: King’s College London
Salma Ayis: King’s College London
Joanne Higgins: National Institute for Health and Care Excellence
Stephen Keevil: King’s Technology Evaluation Centre
Cornelius Lewis: King’s Technology Evaluation Centre
Janet Peacock: King’s Technology Evaluation Centre

Applied Health Economics and Health Policy, 2017, vol. 15, issue 2, No 3, 139-154

Abstract: Abstract 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.

Date: 2017
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DOI: 10.1007/s40258-016-0277-7

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