Fig 1.
Ovals represent the MASLD-related health states. Solid arrows indicate the possible transitions that individuals may undergo within the model, while dashed arrows depict the probabilities of transitioning to the death state. Abbreviations: CVD, cardiovascular disease; F, fibrosis stage; HCC, hepatocellular carcinoma; MASLD, metabolic dysfunction-associated steatotic liver disease.
Table 1.
Model’s input parameters.
Table 2.
Cost-utility analysis outcomes in individuals with metabolic syndrome and individuals with obesity at screening age of 50 years.
Fig 2.
The graph showing ICERs of screening strategies compared to no screening across screening ages ranging from 30 to 80 years.
Fig 3.
Tornado diagrams of (a) FIB-4 + TE, (b) SAFE+TE, and (c) TE alone compared to no screening, in individuals with metabolic syndrome.
Abbreviations: DC, decompensated cirrhosis; F, fibrosis stage; FIB-4, fibrosis-4 index; LSM, liver stiffness measurement; MASLD, metabolic dysfunction-associated steatotic liver disease; MetS, metabolic syndrome; QALY, quality-adjusted life-year; SAFE, steatosis-associated fibrosis estimator score; sig F, significant fibrosis; spec, specificity; TE, transient elastography; THB, Thai baht; Tp, transition probability.
Fig 4.
Tornado diagrams of (a) FIB-4 + TE, (b) SAFE+TE, and (c) TE alone compared to no screening, in individuals with obesity.
Abbreviations: DC, decompensated cirrhosis; F, fibrosis stage; FIB-4, fibrosis-4 index; LSM, liver stiffness measurement; MASLD, metabolic dysfunction-associated steatotic liver disease; QALY, quality-adjusted life-year; SAFE, steatosis-associated fibrosis estimator score; sig F, significant fibrosis; spec, specificity; TE, transient elastography; THB, Thai baht; Tp, transition probability.
Fig 5.
Cost-effectiveness acceptability curves.
(a) Individuals with metabolic syndrome and (b) individuals with obesity. Abbreviations: FIB-4, fibrosis-4 index; MetS, metabolic syndrome; QALY, quality-adjusted life-year; SAFE, steatosis-associated fibrosis estimator score; TE, transient elastography; THB, Thai baht.
Fig 6.
Bar charts show the annual number of transient elastography screening cases for each strategy, and overlaid lines depict the corresponding annual budget impact of each strategy (in million THB). Abbreviations: FIB-4, fibrosis-4 index; MetS, metabolic syndrome; SAFE, steatosis-associated fibrosis estimator score; TE, transient elastography; THB, Thai baht.