Cost-effectiveness of risk-stratified hepatocellular carcinoma screening using the age-male-albumin-bilirubin-platelets score-based stepwise enrichment approach in patients with cirrhosis
Yun-Bo Zhang, Yu-Xuan Li, Wen-Di Zhang, Xian-Bin Hou, Rui Li, Ru-Yi Xia, Ming-Wang Shen, Zhuo-Ru Zou, Gui-Hua Zhuang
Yun-Bo Zhang, Yu-Xuan Li, Wen-Di Zhang, Xian-Bin Hou, Ming-Wang Shen, Zhuo-Ru Zou, Gui-Hua Zhuang, Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, Shaanxi Province, China
Rui Li, Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg 69120, Baden-Württemberg, Germany
Ru-Yi Xia, School of Public Health, Xi’an Medical University, Xi’an 710021, Shaanxi Province, China
Co-corresponding authors: Zhuo-Ru Zou and Gui-Hua Zhuang.
Author contributions: Zhuang GH and Zou ZR contributed equally to this work as co-corresponding authors; Zhang YB, Zhuang GH and Zou ZR conceived and designed the study; Zhang YB, Li YX, Zhang WD collected the data; Zhang YB analyzed the data, and carried out the analysis, wrote the first draft of the manuscript; Hou XB, Li R, Xia RY and Shen MW edited the manuscript; Zhuang GH and Zou ZR critically revised the manuscript; Zhang YB, Li YX, Zhang WD, Hou XB, Li R, Xia RY, Shen MW, Zou ZR, Zhuang GH contributed to writing the paper and agreed with the manuscript results and conclusions; all authors read and approved the final manuscript.
AI contribution statement: AI tools (specifically ChatGPT) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Supported by the China National Science and Technology Major Project, No. 2023ZD0501400; National Natural Science Foundation of China, No. 82304206; and China Postdoctoral Science Foundation, No. BX20220254 and No. 2023M732773.
Institutional review board statement: This study was based on a Markov model using published secondary data and did not involve any direct interaction with human or animal subjects. Therefore, institutional review board approval was not required.
Informed consent statement: This study does not involve any human subjects, human data, or human tissue. Therefore, no informed consent was required from any participant.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article. None of the funders had any role in study design, data collection, data analysis, interpretation, decision to publish, or preparation of the manuscript.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: All data generated or analysed during this study are included in this published article and its
Supplementary material.
Corresponding author: Gui-Hua Zhuang, PhD, Professor, Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, No. 76 Yanta West Road, Xi’an 710061, Shaanxi Province, China.
zhuanggh@mail.xjtu.edu.cn
Received: April 3, 2026
Revised: May 23, 2026
Accepted: June 4, 2026
Published online: December 14, 2026
Processing time: 200 Days and 20.7 Hours
