Staff Profile

@article{Mueller2022,

title = {Duration and cost-effectiveness of hepatocellular carcinoma surveillance in hepatitis C patients after viral eradication.},

author = {Peter P. Mueller and Qiushi Chen and Turgay Ayer and Gizem Nemutlu and Ali Hajjar and Emily D. Bethea and Mary Linton B. Peters and Brian P. Lee and Naveed Z. Janjua and Fasiha Kanwal and Jagpreet Chhatwal},

url = {https://pubmed.ncbi.nlm.nih.gov/35157959/},

doi = {10.1016/j.jhep.2022.01.027},

issn = {1600-0641},

year  = {2022},

date = {2022-07-01},

urldate = {2022-02-01},

journal = {Journal of hepatology},

volume = {77},

issue = {1},

pages = {55-62},

abstract = {Successful treatment of chronic hepatitis C with oral direct-acting antiviral (DAA) leads to virological cure, however, the subsequent risk of hepatocellular carcinoma (HCC) persists. Our objective was to evaluate the cost-effectiveness of biannual surveillance for HCC in patients cured of hepatitis C and the optimal age to stop surveillance. We developed a microsimulation model of the natural history of HCC in hepatitis C individuals with advanced fibrosis or cirrhosis who achieved virological cure with oral DAAs. We used published data on HCC incidence, tumor progression, real-world HCC surveillance adherence, and costs and utilities of different health states. We compared biannual HCC surveillance using ultrasound and alpha-fetoprotein for varying durations of surveillance (from 5 years to lifetime) versus no surveillance. In virologically-cured patients with cirrhosis, the ICER of biannual surveillance remained below $150,000 per additional quality-adjusted life year (QALY) (range: $79,500-$94,800) when surveillance was stopped at age 70, irrespective of the start age (40-65). Compared with no surveillance, surveillance per 1000 cirrhosis patients detected 130 additional HCCs in 'very early'/early stage and yielded 51 additional QALYs. In virologically-cured patients with advanced fibrosis, the ICER of biannual surveillance remained below $150,000/QALY (range: $124,600-$129,800) when surveillance was stopped at age 60, irrespective of the start age (40-50). Compared with no surveillance, surveillance per 1000 advanced fibrosis patients detected 24 additional HCCs in 'very early'/early stage and yielded 12 additional QALYs. Biannual surveillance for HCC in virologically-cured hepatitis C patients is cost-effective until the age of 70 for cirrhosis patients, and until the age of 60 for patients with stable advanced fibrosis. Individuals who are cured of hepatitis C using oral antiviral drugs remain at risk of developing liver cancer. The value of lifelong screening for liver cancer in these individuals is not known. By simulating the life course of hepatitis C cured individuals, we found that ultrasound-based bi-annual screening for liver cancer is cost-effective up to age 70 in those having cirrhosis and up to age 60 in those having stable advanced fibrosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35687269,

title = {Optimal breast cancer risk reduction policies tailored to personal risk level},

author = {Mehmet A Ergun and Ali Hajjar and Oguzhan Alagoz and Murtuza Rampurwala},

doi = {10.1007/s10729-022-09596-2},

issn = {1386-9620},

year  = {2022},

date = {2022-06-01},

journal = {Health Care Manag Sci},

abstract = {Depending on personal and hereditary factors, each woman has a different risk of developing breast cancer, one of the leading causes of death for women. For women with a high-risk of breast cancer, their risk can be reduced by two main therapeutic approaches: 1) preventive treatments such as hormonal therapies (i.e., tamoxifen, raloxifene, exemestane); or 2) a risk reduction surgery (i.e., mastectomy). Existing national clinical guidelines either fail to incorporate or have limited use of the personal risk of developing breast cancer in their proposed risk reduction strategies. As a result, they do not provide enough resolution on the benefit-risk trade-off of an intervention policy as personal risk changes. In addressing this problem, we develop a discrete-time, finite-horizon Markov decision process (MDP) model with the objective of maximizing the patient's total expected quality-adjusted life years. We find several useful insights some of which contradict the existing national breast cancer risk reduction recommendations. For example, we find that mastectomy is the optimal choice for the border-line high-risk women who are between ages 22 and 38. Additionally, in contrast to the National Comprehensive Cancer Network recommendations, we find that exemestane is a plausible, in fact, the best, option for high-risk postmenopausal women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{hajjar_effective_2019,

title = {\"{E}ffective Preventive Care Management of Multiple Chronic Conditions"},

author = {Ali Hajjar and Oguzhan Alagoz},

url = {https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3398415},

year  = {2019},

date = {2019-06-01},

journal = {SSRN},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{alagoz_benefits_2019,

title = {Benefits and harms of mammography screening for women with Down syndrome: a collaborative modeling study},

author = {Oguzhan Alagoz and Ali Hajjar and Sarocha Chootipongchaivat and Nicolien T. Ravesteyn and Jennifer Yeh and Mehmet Ali Ergun and Harry J. Koning and Brian Chicoine and Barry Martin},

url = {https://pubmed.ncbi.nlm.nih.gov/31385214/},

year  = {2019},

date = {2019-01-01},

urldate = {2019-01-01},

journal = {Journal of General Internal Medicine},

volume = {34},

number = {11},

pages = {2374--2381},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{hajjar_cost-effectiveness_2019,

title = {Cost-effectiveness of adjuvant paclitaxel and trastuzumab for early-stage node-negative, HER2-positive breast cancer},

author = {Ali Hajjar and Mehmet A. Ergun and Oguzhan Alagoz and Murtuza Rampurwala},

url = {https://pubmed.ncbi.nlm.nih.gov/31166995/},

year  = {2019},

date = {2019-01-01},

urldate = {2019-01-01},

journal = {PloS one},

volume = {14},

number = {6},

pages = {e0217778},

keywords = {},

pubstate = {published},

tppubtype = {article}

}