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  • This topic has 4 replies, 4 voices, and was last updated 9 years ago by avatar876.jpegGaj.
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  • #7374
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    If you have a look here:

    http://fixhepc.com/decision-support

    You will find the first iteration of an HCV prescribing decision support tool. Please feel free to take it for a spin and make comments.

    The repository for it is here: https://github.com/gp2u/hcv

    From the README

    The purpose of this tool is to provide a simple user interface to navigate the upcoming Australian HCV treatment Guidelines which are by necessity limited to dealing with the PBS listed medications Sofosbuvir, Ledipasvir, Daclatasvir, Ribavirin, Viekira Pak, and Simeprevir with Interferon.

    The intention is to also support the AASLD and EASL guidelines which have a wider scope.

    You can find a demonstration at https://gp2u.com.au/hcv

    Public contributions are welcome.

    1. SVR Statistics and comments in the code referencing them
    2. Addition of medications like Abbvie Viekira Pak
    3. The AASLD and EASL guidelines code
    4. Support for past treatment status

    For simplicity everything is contained in a single standalone HTML file.

    For more details….. RTFS :-)


    YMMV

    #7380
    avatar876.jpegGaj
    • Guardian Angel
    • ★★★★★
    @gaj

    No programmer but Past Treatment field probably needs to allow more than one choice? Eg Sofosbuvir 12wk and Ribavirin or Eg Sofosbuvir 24wk and NS3 NS4 NS5A


    G3a since ’78 – Dx ’12 – F4 (2xHCC)
    24wk Tx – PEG/Riba/Dac 2013 relapsed
    24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
    16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
    SVR7 – 22/06/17 UND
    SRV12 – 27/07/17 UND
    SVR24 – 26/10/17 UND
    :cheer: :cheer: :cheer:

    #7411
    Avatar photoArcher
    • Topics: 9
    • Replies: 61
    • Total: 70
    • Recovery Champion
    • ★★★★
    @archer

    I don’t think the aim is to provide all permutations in the tool GAJ (ie some permutations may have same outcome) – so much as we be sure that the critical DAA components in each permutation which would produce or require a reframing / diversion in the decision trees are accounted for – Unless in the end, to achieve this, it does require all permutations hope Im making sense archer.

    #7412
    Tim-Naylor-google
    • Topics: 1
    • Replies: 11
    • Total: 12
    • Acolyte
    • ★★
    @tim-naylor-google

    I agree that more options for previous treatment might be useful.
    Some components of previous treatments may affect the recommendation due to resistance.
    I was unsuccessfully treated with un-pegylated interferon alone in 1997.


    GT1 F4 compensated, I/F non-responder 1997
    @2015-11-06 VL 3.5 x 10^6, started Twinvir
    @2015-12-31 VL:UND
    @2016-01-29 started 2nd 12 weeks of Twinvir
    @2016-03-01 ALT=42 AST=42, other LFT in normal range

    #7413
    avatar876.jpegGaj
    • Guardian Angel
    • ★★★★★
    @gaj

    I agree that some variations may (probably will?) give the same outcome.
    But using me as an example which past treatment fail should be selected? Interferon/riba or NS3/4/5? I had both in trial but wonder whether the outcome from both choices could be the same? Admittedly mine would be a small subset. And in Tim’s case possibly Inferferon/Riba may be considered close enough?

    ……..but what about the case of someone who failed Harvoni (branded or generic), should the selection be for failing Sofosbuvir Xwks or failing NS3/4/5? How would that decision be arrived at? And would the outcome be the same for either?

    Ouch Tim, that would be 3 jabs per week!


    G3a since ’78 – Dx ’12 – F4 (2xHCC)
    24wk Tx – PEG/Riba/Dac 2013 relapsed
    24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
    16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
    SVR7 – 22/06/17 UND
    SRV12 – 27/07/17 UND
    SVR24 – 26/10/17 UND
    :cheer: :cheer: :cheer:

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