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Effectiveness of direct-acting antiviral therapy for hepatitis C in difficult-to-treat patients in a safety-net health system: a retrospective cohort study

Overview of attention for article published in BMC Medicine, November 2017
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  • Good Attention Score compared to outputs of the same age (67th percentile)

Mentioned by

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6 tweeters

Citations

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39 Dimensions

Readers on

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60 Mendeley
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Title
Effectiveness of direct-acting antiviral therapy for hepatitis C in difficult-to-treat patients in a safety-net health system: a retrospective cohort study
Published in
BMC Medicine, November 2017
DOI 10.1186/s12916-017-0969-3
Pubmed ID
Authors

Christina Yek, Carolina de la Flor, John Marshall, Cindy Zoellner, Grace Thompson, Lisa Quirk, Christian Mayorga, Barbara J. Turner, Amit G. Singal, Mamta K. Jain

Abstract

Direct-acting antivirals (DAAs) have revolutionized chronic hepatitis C (HCV) treatment, but real-world effectiveness among vulnerable populations, including uninsured patients, is lacking. This study was conducted to characterize the effectiveness of DAAs in a socioeconomically disadvantaged and underinsured patient cohort. This retrospective observational study included all patients undergoing HCV treatment with DAA-based therapy between April 2014 and June 2016 at a large urban safety-net health system (Parkland Health and Hospital System, Dallas, TX, USA). The primary outcome was sustained virologic response (SVR), with secondary outcomes including treatment discontinuation, treatment relapse, and loss to follow-up. DAA-based therapy was initiated in 512 patients. The cohort was socioeconomically disadvantaged (56% uninsured and 13% Medicaid), with high historic rates of alcohol (41%) and substance (50%) use, and mental health disorders (38%). SVR was achieved in 90% of patients (n = 459); 26 patients (5%) were lost to follow-up. SVR was significantly lower in patients with decompensated cirrhosis (82% SVR; OR 0.37, 95% CI 0.16-0.85) but did not differ by insurance status (P = 0.98) or alcohol/substance use (P = 0.34). Reasons for treatment failure included loss to follow-up (n = 26, 5%), viral relapse (n = 16, 3%), non-treatment-related death (n = 7, 1%), and treatment discontinuation (n = 4, 1%). Of patients with viral relapse, 6 reported non-compliance and have not been retreated, 5 have been retreated and achieved SVR, 4 have undergone resistance testing but not yet initiated retreatment, and 1 was lost to follow-up. Effective outcomes with DAA-based therapy can be achieved in difficult-to-treat underinsured populations followed in resource-constrained safety-net health systems.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 60 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 60 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 20%
Student > Master 9 15%
Student > Ph. D. Student 8 13%
Student > Doctoral Student 4 7%
Student > Bachelor 3 5%
Other 7 12%
Unknown 17 28%
Readers by discipline Count As %
Medicine and Dentistry 21 35%
Nursing and Health Professions 6 10%
Immunology and Microbiology 3 5%
Psychology 3 5%
Social Sciences 3 5%
Other 3 5%
Unknown 21 35%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 May 2019.
All research outputs
#7,227,053
of 23,008,860 outputs
Outputs from BMC Medicine
#2,560
of 3,455 outputs
Outputs of similar age
#142,573
of 437,479 outputs
Outputs of similar age from BMC Medicine
#33
of 47 outputs
Altmetric has tracked 23,008,860 research outputs across all sources so far. This one has received more attention than most of these and is in the 68th percentile.
So far Altmetric has tracked 3,455 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 43.6. This one is in the 25th percentile – i.e., 25% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 437,479 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
We're also able to compare this research output to 47 others from the same source and published within six weeks on either side of this one. This one is in the 29th percentile – i.e., 29% of its contemporaries scored the same or lower than it.