Indication 1: variceal bleeding | Indication 2: refractory ascites | |||||
TIPSS | Standard care | Source | TIPSS | Standard care | Source | |
Survival at 12 months | 0.860 | 0.610 | 10 | 0.928* | 0.553* | 11 |
Survival at 24 months | 0.860 | 0.610 | 10 | 0.890* | 0.241* | 11 |
TIPSS technical success | 0.980 | N/A | 19 | 0.980 | N/A | 19 |
Shunt dysfunction | 0.070 | N/A | 40 | 0.030 | N/A | 11 |
Variceal bleeding at 12 months | 0.030 | 0.500 | 10 | 0.044† | 0.182 | 21; 11 |
Variceal bleeding at 24 months | 0.030 | 0.500 | 10 | Assume same rates as 12 months | ||
Ascites at 12 months | 0.130 | 0.330 | 10 | 0.510 | 1.000 | 41 |
HE at 12 months | 0.280 | 0.400 | 10 | 0.345 | 0.333 | 11 |
% HE severe‡ | 0.250 | 0.250 | KOLs | 0.400 | 0.636 | 11 |
SBP at 12 months | N/A | N/A | N/A | N/A | 0.060 | 11 |
Catheter failure at 12 months | N/A | N/A | N/A | N/A | 0.038§ | 20 |
*Survival rates for indication 2 were obtained by estimating parametric survival curves with a lognormal survival function, using 12-month patient data reported in Bureau et al. For further details, see online supplemental appendix 2).
†Conservative assumption applied as per economic evaluation of TIPSS for RA by Shen et al.21 The rate of variceal bleeding from Bureau et al is equal to 0% for TIPSS and 18.2% for standard care.11
‡Absolute % of severe HE calculated as overall HE rate multiplied by % HE severe. The remaining HE episodes are classified as mild. % of severe HE obtained from: KOL assumption for variceal bleeding; Bureau et al11 as number of OHE episodes grade >2/total number of OHE episodes.
§% with catheter failure at 12 months obtained by extrapolating value from source at 41 weeks (3%), assuming proportional rates between weeks 41 and 52.
HE, hepatic encephalopathy; KOL, key opinion leader; N/A, not applicable; RA, refractory ascites; SBP, spontaneous bacterial peritonitis; TIPSS, transjugular intrahepatic stent shunt.