metricas
covid
Buscar en
Gastroenterología y Hepatología (English Edition)
Toda la web
Inicio Gastroenterología y Hepatología (English Edition) Patient journey of individuals tested for HCV in Spain: LiverTAI, a retrospectiv...
Journal Information

Statistics

Follow this link to access the full text of the article

Original article
Patient journey of individuals tested for HCV in Spain: LiverTAI, a retrospective analysis of EHRs through natural language processing
Recorrido hospitalario de los pacientes testados para VHC en España: LiverTAI, un análisis retrospectivo de las HCE a través del procesamiento del lenguaje natural
José Luis Calleja Paneroa, Gema de la Pozab, Lorena Hidalgoc, María Victoria Aguilera Sancho-Tellod, Xavier Torrase, Regina Santos de Lamadridf, Claudia Matég, Gloria Sánchez Antolính,
Corresponding author
a Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
b Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
c Hospital Universitario Infanta Sofía, Madrid, Spain
d Hospital Universitario y Politécnico La Fe, Valencia, Spain
e Hospital de la Santa Creu i Sant Pau, CIBER-EHD, Barcelona, Spain
f AbbVie Inc., North Chicago, IL, USA
g MedSavana S.L., Madrid, Spain
h Hospital Universitario Rio Hortega, Valladolid, Spain
Read
163
Times
was read the article
25
Total PDF
138
Total HTML
Share statistics
 array:22 [
  "pii" => "S2444382423001347"
  "issn" => "24443824"
  "doi" => "10.1016/j.gastre.2022.10.014"
  "estado" => "S300"
  "fechaPublicacion" => "2023-08-01"
  "aid" => "2005"
  "copyright" => "The Author(s)"
  "copyrightAnyo" => "2022"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Gastroenterol Hepatol. 2023;46:491-503"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2444382423001359"
    "issn" => "24443824"
    "doi" => "10.1016/j.gastre.2022.10.015"
    "estado" => "S300"
    "fechaPublicacion" => "2023-08-01"
    "aid" => "2012"
    "copyright" => "Elsevier España, S.L.U."
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Gastroenterol Hepatol. 2023;46:504-11"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Impact of proactive of infliximab monitoring using the Bayesian approach in the maintenance phase in patients with inflammatory bowel disease"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "504"
          "paginaFinal" => "511"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Impacto de la monitorizaci&#243;n proactiva de infliximab en fase de mantenimiento mediante estimaci&#243;n bayesiana en pacientes con enfermedad inflamatoria intestinal"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 792
              "Ancho" => 1675
              "Tamanyo" => 73495
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Clinical remission for diagnosis &#40;CU Vs CD&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Lidia Serrano D&#237;az, Carles Iniesta Naval&#243;n, Rosa G&#243;mez Esp&#237;n, Isabel Nicol&#225;s de Prado, Lorena Rentero Redondo"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Lidia Serrano"
              "apellidos" => "D&#237;az"
            ]
            1 => array:2 [
              "nombre" => "Carles Iniesta"
              "apellidos" => "Naval&#243;n"
            ]
            2 => array:2 [
              "nombre" => "Rosa G&#243;mez"
              "apellidos" => "Esp&#237;n"
            ]
            3 => array:2 [
              "nombre" => "Isabel Nicol&#225;s de"
              "apellidos" => "Prado"
            ]
            4 => array:2 [
              "nombre" => "Lorena Rentero"
              "apellidos" => "Redondo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382423001359?idApp=UINPBA00004N"
    "url" => "/24443824/0000004600000007/v2_202311101332/S2444382423001359/v2_202311101332/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Patient journey of individuals tested for HCV in Spain&#58; LiverTAI&#44; a retrospective analysis of EHRs through natural language processing"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "491"
        "paginaFinal" => "503"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Jos&#233; Luis Calleja Panero, Gema de la Poza, Lorena Hidalgo, Mar&#237;a Victoria Aguilera Sancho-Tello, Xavier Torras, Regina Santos de Lamadrid, Claudia Mat&#233;, Gloria S&#225;nchez Antol&#237;n"
        "autores" => array:8 [
          0 => array:3 [
            "nombre" => "Jos&#233; Luis"
            "apellidos" => "Calleja Panero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Gema"
            "apellidos" => "de la Poza"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Lorena"
            "apellidos" => "Hidalgo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Mar&#237;a Victoria"
            "apellidos" => "Aguilera Sancho-Tello"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Xavier"
            "apellidos" => "Torras"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Regina"
            "apellidos" => "Santos de Lamadrid"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Claudia"
            "apellidos" => "Mat&#233;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff0035"
              ]
            ]
          ]
          7 => array:4 [
            "nombre" => "Gloria"
            "apellidos" => "S&#225;nchez Antol&#237;n"
            "email" => array:1 [
              0 => "gsanchezan@saludcastillayleon.es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff0040"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:8 [
          0 => array:3 [
            "entidad" => "Hospital Universitario Puerta de Hierro&#44; Majadahonda&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Hospital Universitario de Fuenlabrada&#44; Fuenlabrada&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Hospital Universitario Infanta Sof&#237;a&#44; Madrid&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Hospital Universitario y Polit&#233;cnico La Fe&#44; Valencia&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Hospital de la Santa Creu i Sant Pau&#44; CIBER-EHD&#44; Barcelona&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "AbbVie Inc&#46;&#44; North Chicago&#44; IL&#44; USA"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
          6 => array:3 [
            "entidad" => "MedSavana S&#46;L&#46;&#44; Madrid&#44; Spain"
            "etiqueta" => "g"
            "identificador" => "aff0035"
          ]
          7 => array:3 [
            "entidad" => "Hospital Universitario Rio Hortega&#44; Valladolid&#44; Spain"
            "etiqueta" => "h"
            "identificador" => "aff0040"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Recorrido hospitalario de los pacientes testados para VHC en Espa&#241;a&#58; LiverTAI&#44; un an&#225;lisis retrospectivo de las HCE a trav&#233;s del procesamiento del lenguaje natural"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1614
            "Ancho" => 3341
            "Tamanyo" => 328048
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Study population groups by HCV status and follow-up departments&#46; &#40;A&#41; The number and percentage of patients included in the FAS are shown according to HCV seropositivity and viremia&#46; Red shading represents HCV seropositive patients and blue shading corresponds to HCV seronegative patients&#46; Within HCV seropositive patients&#44; HCV active viremia &#40;orange&#41;&#44; negative viremia &#40;green&#41;&#44; or unknown viremia &#40;gray&#41; patients are described&#46; &#40;B&#41; The FAS is shown divided into patients with follow up at core departments or other departments&#46; As above&#44; HCV seropositivity and viremia are shown in terms of patient number and percentage&#44; following the same color coding&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Hepatitis C virus &#40;HCV&#41; is one of the major global causes of death and morbidity&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">1</span></a> The global prevalence of individuals infected with HCV in 2019 was estimated by the World Health Organization &#40;WHO&#41; at 0&#46;75&#37; of the population&#44; which corresponds to approximately 58 million people&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">2&#44;3</span></a> Even though the prevalence of HCV infection shows considerable variation across the globe&#44; countries with a past or present history of iatrogenic infections &#40;that is&#44; infections due to the activity of a physician or medical therapy&#41; show the highest infection rates&#46; In this context&#44; the WHO developed the Global Health Sector Strategy &#40;2016&#8211;2021&#41;&#44; aiming to eliminate viral hepatitis as a significant public health threat by 2030&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">3&#44;4</span></a> Of note&#44; recent updates show Spain as the second closest worldwide toward achieving this goal&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">HCV is primarily transmitted through percutaneous exposure to blood&#44; owing to medical procedures or sharing contaminated devices for injection drug use&#46; Additionally&#44; mother-to-infant transmission and sexual transmission also occur but are less common&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">3&#44;4</span></a> HCV infection is a slowly progressive disease&#44; often associated with end-stage liver disease&#44; liver cirrhosis&#44; and hepatocellular carcinoma&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">6</span></a> Epidemiological studies show an association between HCV and several extrahepatic manifestations&#44; including insulin resistance&#44; type 2 diabetes mellitus&#44; glomerulopathies&#44; non-Hodgkin lymphomas &#40;NHL&#41;&#44; cardiovascular disease&#44; and neurological and psychiatric manifestations&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Due to this disease&#39;s silent course&#44; a substantial proportion of patients are undiagnosed and hence unaware of their viral infection&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">2&#44;8</span></a> Although the development of oral direct-acting antiviral &#40;DAAs&#41; agents has changed the HCV field dramatically by showing high cure rates&#44; only diagnosed patients can benefit from these therapies&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">6</span></a> Indeed&#44; one of the main objectives of the Spanish strategic national and regional plans for HCV elimination since 2019 is to promote early diagnosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">9&#44;10</span></a> Though efforts are ongoing&#44; it has been estimated that less than 25&#37; of viremic infections in 2020 were diagnosed&#44; and fewer than 10&#37; were initiated on treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> Therefore&#44; implementing targeted testing to detect HCV-infected patients through hospital-wide efforts is crucial to treat infected patients in a timely manner&#46; The strategy could include HCV screening in diverse hospital departments prior to any surgery&#44; oncological intervention&#44; or treatment with biologics&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Since 2015&#8211;2017&#44; which falls within the study period encompassed in this work &#40;2014&#8211;2018&#41;&#44; several novel approaches to HCV testing and treatment have been implemented&#46; The proportion of Spanish hospitals that apply reflex testing&#44; in which the same biological sample is used for HCV antibody and RNA detection&#44; increased from 31&#37; to 89&#37; from 2017 to 2019&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">11&#44;12</span></a> Unfortunately&#44; the COVID-19 pandemic has had a negative impact on the progress of reflex testing implementation&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">13</span></a> The use of DAAs was introduced in 2015&#44; extending to pangenotypic options a few years later&#44; which precludes genotyping and potentially reduces the time to full HCV diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">14</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The analysis of vast amounts of real-world data &#40;RWD&#41; holds great potential to determine the number of hospital patients being tested for HCV in different hospital areas and their linkage to care&#46; The information in patients&#8217; electronic health records &#40;EHRs&#41; represents an important source of RWD&#59; particularly&#44; recent studies have highlighted the value of the unstructured clinical notes in EHRs to describe patients&#8217; clinical characteristics&#44; management&#44; and journey within the hospital&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">15&#8211;25</span></a> By applying natural language processing &#40;NLP&#41; and machine learning to EHRs of hospital patients tested for HCV using the previously validated <span class="elsevierStyleItalic">EHRead&#174;</span> technology&#44;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">15&#8211;25</span></a> we detected the pre-testing patient journey and linkage to care&#44; conveying a real-world snapshot of HCV testing and viremia status within different hospital departments&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Data source</span><p id="par0030" class="elsevierStylePara elsevierViewall">This study was based on the secondary use of data captured in the EHRs of 6 third-level hospitals within the Spanish National Healthcare Network&#44; namely&#58; Hospital Universitario de Fuenlabrada &#40;Madrid&#41;&#44; Hospital Universitario y Polit&#233;cnico La Fe &#40;Valencia&#41;&#44; Hospital Universitario Puerta de Hierro &#40;Madrid&#41;&#44; Hospital Universitario Infanta Sof&#237;a &#40;Madrid&#41;&#44; Hospital del R&#237;o Hortega &#40;Valladolid&#41;&#44; and Hospital de la Santa Creu i Sant Pau &#40;Barcelona&#41;&#46; The data source was free-text information in EHRs&#44; including outpatient clinic reports&#44; discharge reports&#44; emergency reports&#44; and other medical reports&#46; Structured data from hospital pharmacy&#44; microbiology&#44; radiology&#44; and elastography reports were not fully available for all sites and were therefore not included in the data set&#46; Data were collected between January 1&#44; 2014&#44; and December 31&#44; 2018 &#40;study period&#41; from all available services and departments in each participating site&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study design</span><p id="par0035" class="elsevierStylePara elsevierViewall">This was a retrospective and multicenter study where we conducted a cross-sectional analysis of all patients at the time of inclusion&#46; Index date &#40;inclusion date&#41; corresponds to the time when an HCV serology test was documented in the EHRs&#46; Follow up comprised the time from index date to the last EHR available for each patient within the study period &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; top&#41;&#46; The LiverTAI study was designed to fulfill the following objectives&#58; to identify the potential factors associated with HCV infection in the Spanish population&#44; to generate a predictive model of undiagnosed HCV patient detection &#40;subject of a future publication&#41;&#44; to describe the demographic and clinical characteristics of patients tested for HCV&#44; and to reflect their pre-testing patient journey&#46; This publication focuses on the latter two objectives and the potential factors associated with HCV infection&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Study population</span><p id="par0040" class="elsevierStylePara elsevierViewall">The full analysis set &#40;FAS&#41; included all adult patients in the source population tested for HCV infection during the study period&#46; Patients with documented prior history of HCV &#40;HCV serology&#44; PCR&#44; genotype&#44; or HCV-specific treatment&#41; and patients with less than one year of follow up after HCV serology testing were excluded from the study&#46; Within the study period&#44; patients with an HCV-specific treatment or genotype defined&#44; or patients with positive HCV PCR but no information regarding HCV serology testing were considered as having active viremia &#40;i&#46;e&#46;&#44; HCV serology and RNA positive&#41;&#46; Patients with at least one visit during follow up to the Gastroenterology&#44; Internal Medicine&#44; or Infectious Disease departments were classified into the &#8220;core departments&#8221; group&#46; That visit had to include a mention to the term &#8220;HCV&#8221; or related terms such as serology&#44; PCR&#44; genotype&#44; or specific HCV treatment&#46; Patients that were not detected to have an HCV-related visit to the core departments were included in the &#8220;other departments&#8221; group&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Extraction of unstructured free text from EHRs</span><p id="par0045" class="elsevierStylePara elsevierViewall">Clinical data were obtained using the <span class="elsevierStyleItalic">EHRead&#174;</span> technology&#44; as described previously&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">15&#8211;25</span></a> Briefly&#44; the free text from de-identified&#44; processed EHRs is extracted using NLP&#44; machine learning&#44; and deep learning techniques and translated into a synthetic database&#46; Using the information obtained from this processing &#40;study database&#41;&#44; a statistical model was generated to describe the population that has undergone HCV testing&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">External validation of EHRead&#174; performance</span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">EHRead&#174;</span> was assessed regarding its ability to identify key variables associated with the study disease within patients&#8217; EHRs&#44; as described previously&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">18&#44;20&#8211;23</span></a> Briefly&#44; a comparison was established between a physician-annotated set of EHRs&#44; &#40;i&#46;e&#46;&#44; &#8220;gold standard&#8221;&#41;&#44; and the output of <span class="elsevierStyleItalic">EHRead&#174;</span> upon reading that same set of EHRs&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a> The &#8220;output vs&#46; gold standard&#8221; comparison is reflected in the standard calculated metrics of precision&#44; recall&#44; and their harmonic mean &#40;F1-score&#41;&#44; as reflected in the Results section &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Table 1</a>&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Analysis at index date</span><p id="par0055" class="elsevierStylePara elsevierViewall">For each patient&#44; the index date was defined as the time point within the study period when available data on HCV testing by serology was first identified&#46; For patients with diagnosis of HCV&#44; information from available records prior to the study period were also considered&#46; A time window of &#177;6 months from index date was used for data extraction and analysis&#44; unless otherwise stated in the table footnotes&#44; and the closest value to the index date was considered&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Patient journey and linkage to care analyses</span><p id="par0060" class="elsevierStylePara elsevierViewall">The number of visits to the different services both prior to and after HCV serology mentions was analyzed for the different groups according to HCV seropositivity&#44; viremia&#44; and follow-up department&#46; Patient journeys were displayed in alluvial diagrams&#46; Linkage to care was reflected by mean times between HCV serology and HCV PCR&#44; genotyping&#44; or treatment&#44; as well as time-to-event curves showing cumulative incidence rates of first mentions of these variables&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Statistical data analyses</span><p id="par0065" class="elsevierStylePara elsevierViewall">Frequency tables were generated for categorical variables&#44; whereas continuous variables were described using summary tables&#46; The number of non-evaluable outcomes and missing data is also provided&#44; where relevant&#46; Data was analyzed and represented using &#8220;R&#8221; software&#44; version 4&#46;0&#46;2&#46; To statistically compare subgroups regarding categorical variables&#44; we tested the null hypothesis &#40;equal proportions&#41; using Fisher&#39;s exact tests&#46; For subgroup comparison of numeric variables&#44; we tested the null hypothesis &#40;equal means&#41; using independent-samples T tests&#46; Welch&#39;s adjustment was incorporated for unequal variances&#46; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> tests were performed instead if the normality assumption &#40;Shapiro&#8211;Wilk test&#41; was not met&#46; In time-to-event analyses&#44; Cox proportional hazards models were used&#46; Differences were considered statistically significant when <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05 in two-tailed tests&#46; <span class="elsevierStyleItalic">p</span> values were adjusted by the Benjamini &#38; Hochberg method when accounting for multiple hypothesis testing&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Results</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Study population and groups</span><p id="par0070" class="elsevierStylePara elsevierViewall">A total of 49&#44;704&#44;746 EHRs corresponding to a source population of 2&#44;440&#44;358 patients were analyzed&#46; External evaluation metrics of variable detection yielded F1-scores &#8805;80&#37;&#44; indicating robust identification of key clinical terms by the <span class="elsevierStyleItalic">EHRead&#174;</span> NLP system &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Table 1</a>&#41;&#46; Within the source population&#44; 16&#44;261 patients were tested for HCV &#40;FAS&#41;&#46; The dynamics of patient inclusion and follow up within the study period are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> &#40;bottom&#41;&#46; Patient inclusion&#44; which was performed throughout the study period&#44; was overall constant across the years&#46; The scarcity of hospital visits pre-testing indicates that many patients were new or did not visit the hospital regularly before being tested for HCV&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A shows the distribution of the FAS into the study groups according to HCV seropositivity and viremia&#46; Within the FAS&#44; HCV seropositivity was detected in 16&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2659&#41; of patients&#46; Within the HCV seropositive group&#44; 37&#46;7&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1003&#41; had an HCV positive PCR result&#44; genotype&#44; or treatment&#44; comprising the active viremia group&#46; The HCV negative viremia proportion of patients was 18&#46;6&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>494&#41; and those with unknown viremia &#40;no mention of a PCR or its result&#41; represented 43&#46;7&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1162&#41;&#46; The remaining HCV-tested patients &#40;83&#46;6&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#44;602&#41; had either a negative &#40;50&#46;6&#37;&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8221&#41; or unknown &#40;33&#46;1&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5381&#41; HCV serology test result and make up the HCV seronegative group&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Aiming to categorize patients according to testing for a suspected HCV infection vs&#46; routine screening&#44; we detected whether they had an HCV-related visit to an HCV-related department during their follow-up period &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Table 2</a>&#41;&#46; As expected&#44; patients detected as HCV seropositive had significantly more visits to the Gastroenterology and Infectious Disease departments &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; than HCV seronegative patients&#46; Patients with HCV active viremia had significantly more visits to the Gastroenterology &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;041&#41;&#44; Infectious Disease&#44; Obstetrics and Gynecology&#44; Neurology&#44; and Endocrinology departments &#40;all <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; than those with negative viremia&#46; Patients with HCV unknown viremia predominantly visited the Emergency &#40;63&#46;3&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>736&#41;&#44; Gastroenterology &#40;56&#46;8&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>660&#41;&#44; Surgery &#40;25&#46;3&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>294&#41;&#44; or Obstetrics and Gynecology &#40;23&#46;3&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>271&#41; departments&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Patients in the core vs&#46; other departments were also grouped according to HCV seropositivity and viremia&#46; Within the FAS&#44; 38&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6173&#41; of patients were followed by core departments and 62&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44;088&#41; in other departments &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46; HCV seropositivity was detected in 26&#46;2&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1619&#41; of core department patients&#44; which was significantly higher &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;09 &#91;2&#46;84&#44; 3&#46;37&#93;&#41; than for patients followed in other departments &#40;10&#46;3&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1040&#41;&#46; Active viremia was detected in 43&#46;5&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>704&#41; of the core department group but only in 28&#46;75&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>299&#41; of those in other departments &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;91 &#91;1&#46;61&#44; 2&#46;26&#93;&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Patient characteristics</span><p id="par0090" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the patient characteristics in the FAS and study groups&#46; The distribution of patients followed in core vs&#46; other departments are shown in <a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Table 3</a> and <a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Table 4</a>&#44; respectively&#46; The median &#40;Q1&#44; Q3&#41; age of the FAS was 50 &#40;37&#44; 65&#41; years&#59; 43&#46;8&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7129&#41; were male &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Among HCV seropositive patients&#44; the median &#40;Q1&#44; Q3&#41; age was 53 &#40;41&#44; 63&#41; years and 51&#46;4&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1367&#41; were male&#44; reflecting significantly older patients and more males than in the HCV seronegative group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 for both variables&#41;&#46; The proportion of males with HCV active viremia was also significantly higher than with negative viremia &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;24 &#91;1&#46;11&#44; 1&#46;36&#93;&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Regarding the potential factors associated with HCV infection&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows that detection of injection drug users &#40;IDU&#41;&#44; blood transfusions&#44; piercings&#44; or tattoos was significantly higher in the HCV seropositive than the seronegative group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 for all variables&#41;&#46; IDU detection was significantly higher both in the HCV seropositive vs&#46; seronegative group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;36 &#91;4&#46;12&#44; 6&#46;97&#93;&#41; and in the HCV active vs&#46; negative viremia group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;52 &#91;1&#46;72&#44; 3&#46;72&#93;&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Comorbidities &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; such as hypertension&#44; diabetes&#44; and dyslipidemia were significantly more detected in the HCV seropositive group than its negative counterpart &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#44; respectively&#41;&#46; Cirrhosis &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;68 &#91;4&#46;97&#44; 6&#46;50&#93;&#41; and hepatocellular carcinoma &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#46;67 &#91;4&#46;87&#44; 9&#46;16&#93;&#41; followed a similar trend&#46; Our data also show a significant positive correlation of HIV co-infection with HCV seropositivity &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;57 &#91;3&#46;49&#44; 5&#46;98&#93;&#41; and active infection &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;53 &#91;2&#46;32&#44; 5&#46;47&#93;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The most common genotype in FAS patients with active HCV viremia was HCV genotype 1 &#40;77&#46;7&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>342&#41;&#44; particularly genotype 1b &#40;41&#46;4&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>182&#41; and genotype 1a &#40;20&#46;2&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>89&#41;&#44; followed by genotype 3 &#40;14&#46;5&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&#41; and genotype 4 &#40;7&#46;0&#37;&#59; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>31&#41; &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Table 5</a>&#41;&#46; HCV genotype was significantly more detected in active viremia core department patients than in others &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#44; <span class="elsevierStyleItalic">OR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;66 &#91;3&#46;36&#44; 6&#46;54&#93;&#41;&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">HCV patient journey prior to first HCV testing at hospitals</span><p id="par0105" class="elsevierStylePara elsevierViewall">We analyzed patients&#8217; pre-testing journey to detect the hospital services visited prior to HCV serology testing &#40;index date&#41;&#46; As shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> and <a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Fig&#46; 1</a>&#44; a prominent peak in patients&#8217; hospital visits at index is observed&#46; Analysis of the FAS revealed that the Gastroenterology department is visited more by patients in the HCV seropositive vs&#46; seronegative group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; Conversely&#44; visits to the Obstetrics and Gynecology department are significantly more prominent in the HCV seronegative group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">As shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#44; HCV seropositive patients followed in other departments visit the Obstetrics and Gynecology&#44; Nephrology&#44; and Hematology departments more than their core counterparts &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 for all departments&#41;&#46; Interestingly&#44; there is a clear abundance of HCV seronegative patients in the Obstetrics and Gynecology and Rheumatology departments&#46; The Emergency department is frequently visited by all groups&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">As shown in <a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#44; the top departments where HCV testing was first mentioned were Gastroenterology &#40;17&#46;3&#37;&#41;&#44; Obstetrics and Gynecology &#40;12&#46;4&#37;&#41;&#44; and Internal Medicine &#40;10&#46;7&#37;&#41;&#46; HCV active viremia levels were highest in the Gastroenterology &#40;10&#46;4&#37;&#41;&#44; Medical Oncology &#40;8&#46;1&#37;&#41;&#44; and Surgery &#40;7&#46;9&#37;&#41; departments&#46; Interestingly&#44; the Emergency department was the fourth department with the most first mentions of HCV testing &#40;7&#46;3&#37;&#41;&#44; and the second excluding core departments &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; In fact&#44; though Internal Medicine ranked third regarding HCV testing&#44; several non-core departments such as Medical Oncology&#44; Surgery&#44; Emergency&#44; and Cardiology yielded higher percentages of HCV active viremia than this core department&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Linkage to care for active viremia patients according to their follow-up services</span><p id="par0120" class="elsevierStylePara elsevierViewall">To address linkage to care&#44; we calculated the time between an HCV serology and the subsequent first mention of HCV PCR&#44; genotyping&#44; or treatment in the patients&#8217; EHRs &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Fig&#46; 2</a>&#41; HCV active viremia patients followed in core departments showed a mean &#40;SD&#41; time of 3&#46;9 &#40;8&#46;4&#41; months to HCV PCR&#44; 7&#46;4 &#40;10&#46;5&#41; months to genotyping&#44; and 10&#46;1 &#40;12&#46;1&#41; months to treatment &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Fig&#46; 2&#44; top</a>&#41;&#46; On the other hand&#44; HCV active viremia patients followed in other departments showed mean &#40;SD&#41; times of 5&#46;2 &#40;8&#46;9&#41;&#44; 9&#46;1 &#40;11&#46;8&#41;&#44; and 9&#46;8 &#40;12&#46;5&#41; months &#40;<a class="elsevierStyleCrossRef" href="#sec0115">Supplemental Fig&#46; 2&#44; bottom</a>&#41;&#46; Therefore&#44; there is a longer delay between HCV serology testing and HCV PCRs or genotyping in the other departments than in the core departments&#44; whereas treatments are performed within a similar timeframe in both groups&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Time-to-event analyses revealed HCV active viremia patients followed in core departments presented statistically significant higher cumulative incidence of HCV PCR and genotyping than patients followed in other departments &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46; Specifically&#44; patients in the core departments at any time point during the study period were 2&#46;54 &#40;CI 2&#46;14&#44; 3&#46;01&#41; times more likely to undergo a PCR and 3&#46;49 &#40;CI&#58; 2&#46;66&#44; 4&#46;58&#41; times more likely to be genotyped than patients in other departments&#46; No differences between groups were observed regarding time to treatment &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;181&#44; <span class="elsevierStyleItalic">HR</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;89 &#91;0&#46;76&#44; 1&#46;05&#93;&#41;&#46; These results indicate that&#44; regarding linkage to care&#44; significantly less time passes from HCV diagnosis to performing PCR or genotyping when HCV active viremia patients were followed in core departments than in other departments&#46; First mentions of HCV treatments appeared within a similar timeframe regardless of the follow-up department group&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Discussion</span><p id="par0130" class="elsevierStylePara elsevierViewall">In a novel approach&#44; our RWD study used NLP and machine learning tools to analyze intra-hospital data of HCV-tested patients to detect their patient journey and linkage to care&#46; In doing so&#44; we obtained updated levels of HCV seropositivity and active viremia &#40;16&#46;4&#37; and 6&#46;0&#37;&#44; respectively&#41; in a representative set of Spanish hospitals&#46; Previous estimates of HCV seropositivity in Spain relying on outpatient and primary care data found lower values for these variables&#44; such as the PREVHEP-ETHON Cohort &#40;HCV seropositivity was 1&#46;1&#37;&#41; or a study led by the Spanish National Health System &#40;HCV seropositivity was 0&#46;85&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">26&#44;27</span></a> However&#44; both these studies were performed among the total population&#44; not patients within hospital settings&#46; In hospital settings&#44; an Italian study reported HCV seropositivity at 3&#46;7&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">28</span></a> and a U&#46;S&#46;-based study compared the levels of HCV active viremia at different sites across one academic medical center&#44; which varied from 2&#37; in Family Medicine up to 14&#46;8&#37; in the Inpatient department&#44; similarly to our results&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a> Interestingly&#44; we observed a large proportion of patients with HCV unknown viremia in our study&#44; possibly reflecting loss of follow up or follow up in a different site&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Our RWD results&#44; obtained using AI techniques&#44; further reflected those obtained using traditional observational methods in several aspects&#46; In HCV seropositive patients&#44; we detected significantly higher proportions of cirrhosis and hepatocellular carcinoma&#44; as well as extrahepatic manifestations such as diabetes and hypertension&#44; in line with previous findings&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">7</span></a> The proportion reported by the WHO in 2021 of HIV-coinfected HCV patients is also similar to our results &#40;4&#46;0&#37; vs&#46; 4&#46;1&#8211;7&#46;3&#37; in our study&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">3</span></a> We corroborated known HCV risk factors in our study population&#44; including injection drug use &#40;IDU&#41;&#44; blood transfusions&#44; piercings&#44; or tattoos&#46; The distribution of different HCV genotypes and their subclasses is also in line with previously described epidemiological data for the Spanish population<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">30</span></a> and follows the trend found for high income countries&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">6</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">The main rationale behind using RWD to describe the patient journey of HCV-tested groups is to detect where patients are being followed and tested&#44; and ultimately to accelerate HCV diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">29</span></a> The most visited departments by patients tested for HCV were the Gastroenterology&#44; Obstetrics and Gynecology&#44; Internal Medicine&#44; and Emergency departments&#46; Obstetrics and Gynecology departments perform extensive HCV screenings in pregnant women&#44; which the European Association for the Study of the Liver recommended in 2020 to be performed universally during pregnancy&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">31</span></a> The Rheumatology&#44; Hematology&#44; and Nephrology departments prescribe treatments with biologics&#44; treatments with immunosuppressive side effects&#44; or pre-dialysis treatments&#46; As reflected here&#44; they screen their patients for pathogens to avoid reactivation of latent infections&#44; including HCV&#46; However&#44; it is noteworthy that the Medical Oncology department&#44; in which there are immunosuppressive treatments prescribed as well&#44; did not appear in our study as performing HCV testing to a similar extent&#44; despite presenting the second highest HCV active viremia levels&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">We further analyzed the pre-testing patient journey to study whether we could disambiguate patients that underwent HCV serology testing as part of routine screening from those with suspected HCV infection&#46; The higher granularity obtained by separating patients according to follow-up departments highlighted that many patients with HCV active viremia were detected in departments that perform routine screening &#40;Hematology&#44; Surgery&#44; Rheumatology&#44; and Nephrology&#41;&#46; Unexpectedly&#44; we also found many first mentions of HCV tests at the Emergency department&#46; Interestingly&#44; the Emergency department of a high-level Spanish hospital has recently carried out a plan for HCV screening&#44; yielding 4&#37; of HCV seropositive patients&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Time-to-event analyses reflected an unnecessary wait in non-core departments from HCV serology testing to confirmatory tests &#40;HCV PCR and genotyping&#41;&#46; The advent of reflex testing will accelerate HCV diagnosis&#44; minimizing the risk of loss to follow up between tests and reducing time to treatment&#46; Speedy diagnosis will also reduce the deleterious effects of chronic HCV infection by accelerating the time to HCV treatment for infected patients&#46; According to WHO&#44; only an estimated 21&#37; of people living with hepatitis C knew their HCV status in 2019&#44; whereas the 2030 global testing target is that 90&#37; of HCV-infected individuals will have been diagnosed&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">3</span></a> Therefore&#44; near-universal screening would be necessary to bridge this gap&#44; which would entail a substantial healthcare resource burden&#46; Results from this study could help pinpoint the hospital departments where previously unknown HCV active viremia patients are being detected primarily&#44; or departments where HCV testing is lacking&#44; to re-focus screening efforts accordingly within Spanish hospitals&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Limitations</span><p id="par0155" class="elsevierStylePara elsevierViewall">Since we reused clinical data collected in routine practice&#44; the availability of the desired variables in EHRs cannot be guaranteed&#44; which explains the reported missing data&#46; Furthermore&#44; as this is a multicenter study&#44; discrepancies in the EHR systems and type of data collected across settings may have contributed to the heterogeneity of the data&#44; such as site- or physician-specific use of abbreviations and acronyms&#46; Also&#44; the patients included in the study were those for which a first HCV test was detected during the study period&#59; however&#44; if patients were first tested outside the hospital setting or the test was not recorded in their EHRs&#44; we might include patients re-tested for HCV in the population&#44; unawares&#46; This population of re-tested patients could be enriched in HCV seropositive cases and thus contribute to a slight overrepresentation of this group&#46; The present findings are also limited by the extent to which physicians accurately describe patients&#8217; status in their medical records as unstructured data&#46; Limited availability of structured data such as hospital pharmacy&#44; microbiology&#44; or other test reports &#40;e&#46;g&#46;&#44; FibroScan&#174;&#41; prevented their inclusion in this study&#46; While most of the patient-centered clinical information collected in EHRs is unstructured and clinical notes are a rich source of RWD&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">22</span></a> combining unstructured and structured information&#44; as well as complementary data sources &#40;e&#46;g&#46;&#44; genetic databanks&#44; health apps&#44; pharmacy databases&#44; or microbiology and laboratory results&#41; may lead to a most accurate depiction of patients screened for HCV&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conclusion</span><p id="par0160" class="elsevierStylePara elsevierViewall">Using AI techniques&#44; we described the demographic and clinical characteristics of patients tested for HCV and identified potential factors associated with HCV infection in the Spanish population&#44; which were in line with results described previously using traditional methodologies&#46; The pre-testing journey of patients with HCV seropositivity reflected that they were significantly more abundant in HCV-related &#40;core&#41; departments&#46; Other hospital departments also performed widespread HCV testing&#44; such as Obstetrics and Gynecology&#44; Rheumatology&#44; Hematology&#44; or&#44; unexpectedly&#44; Emergency&#44; detecting HCV seropositive cases that would otherwise have remained undiagnosed&#46; These other departments showed significantly delayed times from HCV serology testing to HCV PCR and genotyping during the study period than core departments&#44; reflecting sub-optimal linkage to care&#46; This in-depth analysis of the patient journey of HCV-tested patients highlights testing efforts on behalf of certain hospital departments&#44; but also points for improvement to streamline HCV patient detection and linkage to care&#44; contributing to the ongoing effort of HCV elimination&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Ethical considerations</span><p id="par0165" class="elsevierStylePara elsevierViewall">This study was classified as a &#8220;non-post-authorization study&#8221; by the Spanish Agency of Medicines and Health Products &#40;AEMPS&#41; and was approved by the Independent Ethics Committee of each participating hospital&#46; It was conducted in compliance with legal and regulatory requirements and followed generally accepted research practices described in the Helsinki Declaration in its latest edition&#44; Good Pharmacoepidemiology Practices&#44; and applicable local regulations&#46; Patient consent was waived&#44; since data were retrospectively analyzed from patients&#8217; EHRs&#44; anonymized&#44; and aggregated in an irreversibly dissociated manner&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Funding</span><p id="par0170" class="elsevierStylePara elsevierViewall">This study was funded by <span class="elsevierStyleGrantSponsor" id="gs1">AbbVie Spain S&#46;L&#46;U</span>&#46;</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conflicts of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">JL Calleja has been a consulter and speaker for AbbVie and Gilead Sciences&#46; R Santos de Lamadrid is an employee at AbbVie and may have AbbVie stocks&#46; C Mat&#233; is an employee at MedSavana&#46; G S&#225;nchez-Antol&#237;n has nothing to disclose&#46; G de la Poza has nothing to disclose&#46; MV Aguilera has nothing to disclose&#46; L Hidalgo has nothing to disclose&#46; X Torras has nothing to disclose&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:15 [
        0 => array:3 [
          "identificador" => "xres2008200"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Patients and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1720565"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres2008201"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Pacientes y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1720566"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Patients and methods"
          "secciones" => array:8 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Data source"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Study design"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Study population"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Extraction of unstructured free text from EHRs"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "External validation of EHRead&#174; performance"
            ]
            5 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Analysis at index date"
            ]
            6 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Patient journey and linkage to care analyses"
            ]
            7 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Statistical data analyses"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0055"
          "titulo" => "Results"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Study population and groups"
            ]
            1 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Patient characteristics"
            ]
            2 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "HCV patient journey prior to first HCV testing at hospitals"
            ]
            3 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Linkage to care for active viremia patients according to their follow-up services"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Limitations"
        ]
        9 => array:2 [
          "identificador" => "sec0090"
          "titulo" => "Conclusion"
        ]
        10 => array:2 [
          "identificador" => "sec0095"
          "titulo" => "Ethical considerations"
        ]
        11 => array:2 [
          "identificador" => "sec0100"
          "titulo" => "Funding"
        ]
        12 => array:2 [
          "identificador" => "sec0105"
          "titulo" => "Conflicts of interest"
        ]
        13 => array:2 [
          "identificador" => "xack701482"
          "titulo" => "Acknowledgements"
        ]
        14 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-06-13"
    "fechaAceptado" => "2022-10-16"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1720565"
          "palabras" => array:5 [
            0 => "EHR"
            1 => "NLP"
            2 => "RWD"
            3 => "HCV testing"
            4 => "Linkage to care"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1720566"
          "palabras" => array:5 [
            0 => "HCE"
            1 => "PLN"
            2 => "Datos de vida real"
            3 => "Test VHC"
            4 => "Vinculaci&#243;n a atenci&#243;n sanitaria"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Limited screening and delays in diagnosis and linkage-to-care are barriers for hepatitis C virus &#40;HCV&#41; elimination&#46; The LiverTAI study focused on patients tested for HCV using AI technologies to describe their demographic and clinical characteristics and pre-testing patient journeys&#44; reflecting clinical practice in hospitals&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">LiverTAI is a retrospective&#44; secondary analysis of electronic health records &#40;EHRs&#41; from 6 tertiary Spanish hospitals&#44; extracting unstructured clinical data using natural language processing &#40;NLP&#41; <span class="elsevierStyleItalic">EHRead&#174;</span> technology&#46; Adult subjects with an HCV testing procedure from January 2014 to December 2018 were grouped according to HCV seropositivity and viremia&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">From 2&#44;440&#44;358 patients&#44; 16&#44;261 patients were tested for HCV &#40;13&#44;602 &#91;83&#46;6&#37;&#93; HCV seronegative&#59; 2659 &#91;16&#46;4&#37;&#93; seropositive&#41;&#46; Active HCV viremia appeared in 37&#46;7&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1003&#41; of patients&#44; 18&#46;6&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>494&#41; had negative viremia&#44; and 43&#46;7&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1162&#41; unknown viremia&#46; Patient journeys showed core departments &#40;Gastroenterology&#44; Internal Medicine&#44; and Infectious Disease&#41; and others including Emergency perform ample HCV testing in Spanish hospitals&#44; whereas Medical Oncology lags&#46; Patients were PCR-tested and genotyped significantly faster in core departments &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our results highlight hospital departments responsible for HCV testing&#46; However&#44; further testing was sub-optimal during the study period&#46; Therefore&#44; we underscore the need for HCV screening and reflex testing to accelerate diagnosis and linkage-to-care&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El cribado limitado&#44; los retrasos diagn&#243;sticos y la vinculaci&#243;n a la atenci&#243;n sanitaria son obst&#225;culos para la eliminaci&#243;n del virus de la hepatitis C &#40;VHC&#41;&#46; El estudio LiverTAI se centr&#243; en analizar pacientes testeados para VHC mediante tecnolog&#237;as de IA para describir sus caracter&#237;sticas demogr&#225;ficas&#44; cl&#237;nicas y los recorridos de los pacientes antes del test&#44; reflejando la pr&#225;ctica cl&#237;nica en los hospitales&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">LiverTAI es un an&#225;lisis retrospectivo y secundario de las historias cl&#237;nicas electr&#243;nicas &#40;HCE&#41; de 6 hospitales espa&#241;oles de tercer nivel&#44; en el que se extraen datos cl&#237;nicos no estructurados mediante la tecnolog&#237;a EHRead&#174; de procesamiento del lenguaje natural &#40;PLN&#41;&#46; Los sujetos adultos con un test de VHC desde enero de 2014 hasta diciembre de 2018 se agruparon seg&#250;n la seropositividad y la viremia del VHC&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">De 2&#46;440&#46;358 pacientes&#44; 16&#46;261 fueron testeados para VHC &#40;13&#46;602 &#91;83&#44;6&#37;&#93; seronegativos al VHC&#59; 2&#46;659 &#91;16&#44;4&#37;&#93; seropositivos&#41;&#46; La viremia activa del VHC apareci&#243; en el 37&#44;7&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;003&#41; de los pacientes&#44; el 18&#44;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>494&#41; mostr&#243; viremia negativa y el 43&#44;7&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;162&#41;&#44; viremia desconocida&#46; Los recorridos de los pacientes mostraron que los departamentos <span class="elsevierStyleItalic">core</span> &#40;gastroenterolog&#237;a&#44; medicina interna y enfermedades infecciosas&#41; y otros&#44; incluyendo urgencias&#44; realizan numerosos test de VHC en los hospitales espa&#241;oles&#44; mientras que oncolog&#237;a m&#233;dica se queda atr&#225;s&#46; Los pacientes fueron sometidos a la prueba de la PCR y el genotipo significativamente m&#225;s r&#225;pido en los departamentos <span class="elsevierStyleItalic">core</span> &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados destacan los departamentos hospitalarios responsables de realizar test de VHC mediante pruebas serol&#243;gicas&#46; Sin embargo&#44; las pruebas posteriores &#40;PCR&#44; genotipado&#41; experimentaban retrasos durante el periodo de estudio&#46; Por lo tanto&#44; subrayamos la necesidad de realizar el cribado del VHC y de diagn&#243;stico en un solo paso para acelerar el diagn&#243;stico y la vinculaci&#243;n a la atenci&#243;n sanitaria&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0190" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0115"
          ]
        ]
      ]
    ]
    "multimedia" => array:7 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 3905
            "Ancho" => 2343
            "Tamanyo" => 1476401
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patient inclusion dynamics&#46; EHRead&#174; technology is a system based on NLP that applies machine learning and deep learning to extract&#44; analyze&#44; and interpret the free-text information written in millions of de-identified EHRs&#46; The unstructured free-text information from EHRs from the 6 participating sites is organized in a study database&#46; Analyzed patients did not have a prior history of HCV mentioned in their EHRs and their records contained at least 12 months of follow up after HCV serology testing&#46; The schematic timeline shows each patient being included in the study at the time that an HCV serology test was detected&#44; referred to as index date &#40;black box&#41;&#46; The period from the first EHR to a patient&#39;s index date is referred to as &#8220;pre-testing&#8221; and the time from index date to the last EHR is the follow-up period&#46; In the overall patient inclusion representation of the study period&#44; each row corresponds to a single patient&#46; From their first to last EHRs&#44; throughout the study period&#44; there are months during which no data is available for a patient &#40;blue&#41;&#44; months when hospital visits are detected &#40;red&#41;&#44; or months between hospital visits during which there is no visit detected &#40;white&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1614
            "Ancho" => 3341
            "Tamanyo" => 328048
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Study population groups by HCV status and follow-up departments&#46; &#40;A&#41; The number and percentage of patients included in the FAS are shown according to HCV seropositivity and viremia&#46; Red shading represents HCV seropositive patients and blue shading corresponds to HCV seronegative patients&#46; Within HCV seropositive patients&#44; HCV active viremia &#40;orange&#41;&#44; negative viremia &#40;green&#41;&#44; or unknown viremia &#40;gray&#41; patients are described&#46; &#40;B&#41; The FAS is shown divided into patients with follow up at core departments or other departments&#46; As above&#44; HCV seropositivity and viremia are shown in terms of patient number and percentage&#44; following the same color coding&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1992
            "Ancho" => 3341
            "Tamanyo" => 623358
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Pre-testing visits to hospital departments by HCV test results and department&#46; Alluvial diagrams of pre-testing visits to the different hospital departments in HCV-tested patients followed in the core departments &#40;left&#41; or other departments &#40;right&#41;&#46; The number of patients visiting each hospital department is shown as a function of time&#44; represented per month during the 4-year period prior to index date &#40;HCV serology testing&#44; time 0&#41;&#46; Patients are divided into HCV seropositive &#40;A&#41; and seronegative &#40;B&#41;&#46; The 11 most visited hospital departments by patients tested for HCV are color-coded according to the legend and are in order of appearance in each histogram from top &#40;teal&#44; Emergency&#41; to bottom &#40;bright yellow&#44; other&#41;&#46; Note that the rest of the services are included in the &#8220;other&#8221; category&#46; &#42;Statistical differences between the core vs&#46; other department groups shown in the legends were considered significant when <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 in two-tailed tests&#46; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test differences in location &#40;CI 95&#37;&#41; were performed for statistical analysis of HCV seropositive patients &#40;core vs&#46; other depts&#41;&#46; Welch&#39;s <span class="elsevierStyleItalic">t</span>-test differences of group means &#40;CI 95&#37;&#41; were performed for statistical analysis of HCV seronegative patients &#40;core vs&#46; other depts&#41;&#46; &#43;When correcting for multiple testing &#40;adjusted <span class="elsevierStyleItalic">p</span> values&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; CI&#58; Confidence interval&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1440
            "Ancho" => 3341
            "Tamanyo" => 223605
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">HCV testing and HCV active viremia levels per hospital department&#46; Histograms representing the percentage of patients with a first mention of HCV testing in each of the departments &#40;left&#41; and detected as having HCV active viremia &#40;right&#41;&#46; Percentages are calculated respect to the total number of HCV-tested patients that visit each department&#46; The 11 most visited hospital departments are color-coded according to the legend &#40;matching the alluvial diagrams&#41; and in descending order of HCV testing&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 3584
            "Ancho" => 1675
            "Tamanyo" => 327455
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Time-to-event curves regarding HCV PCR&#44; genotypes&#44; and treatment of HCV active viremia patients by department groups&#46; Time-to-event cumulative incidence curves of first mention of HCV PCR &#40;A&#41;&#44; genotype &#40;B&#41;&#44; or treatment &#40;C&#41; during the study period&#44; in months&#46; They show the frequency at which the events &#40;HCV PCR&#44; genotype&#44; or treatment&#41; occur during a 5-year period after HCV serology testing&#46; The number of patients at risk&#44; i&#46;e&#46;&#44; those that do not yet have a mention for the corresponding HCV event at that timepoint&#44; is shown below each graph&#46; Red&#58; patients followed in core departments&#46; Blue&#58; patients followed in other departments&#46; The shaded areas surrounding the curves correspond to the CI &#40;95&#37;&#41;&#46; &#42;Statistical differences between the core vs&#46; other department groups were considered significant when <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 in two-tailed tests&#46; The <span class="elsevierStyleItalic">p</span> values and Cox proportional hazards ratios &#40;CI 95&#37;&#41; are shown in each graph&#46; CI&#58; Confidence interval&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">CI&#58; confidence interval&#59; FAS&#58; full analysis set&#59; HCV active vir &#40;viremia&#41;&#58; positive HCV antibody and RNA test results&#59; HCV negative vir &#40;viremia&#41;&#58; positive HCV antibody and negative RNA test results&#59; HCV unknown vir &#40;viremia&#41;&#58; positive HCV antibody test result and no information regarding RNA test or its result&#59; HIV&#58; human immunodeficiency virus&#59; IDU&#58; injecting drug user&#59; OR&#58; odds ratio &#40;Fisher tests&#41;&#59; Sero&#43;&#58; positive HCV antibody test result&#59; Sero-&#58; negative HCV antibody test result&#59; Vir&#58; viremia&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">FAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">HCV sero&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">HCV sero&#8722;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span> Value<span class="elsevierStyleItalic">OR</span> &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">HCV active vir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">HCV negative vir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">HCV unk vir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span> value<span class="elsevierStyleItalic">OR</span> &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">16261&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2659&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">13602&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">494&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1162&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9132 &#40;56&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1292 &#40;48&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7840 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;69 &#40;0&#46;64&#44; 0&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">444 &#40;44&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">237 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">611 &#40;52&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;76 &#40;0&#46;64&#44; 0&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7129 &#40;43&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1367 &#40;51&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5762 &#40;42&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;31 &#40;1&#46;24&#44; 1&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">559 &#40;55&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">257 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">551 &#40;47&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;24 &#40;1&#46;11&#44; 1&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleItalic">&#40;years&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Median &#40;Q1&#44; Q3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;37&#44; 65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;41&#44; 63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;36&#44; 65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>2&#46;03 &#40;1&#46;36&#44; 2&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52 &#40;44&#44; 63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;41&#44; 62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;39&#44; 65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3191&#46;00 &#40;-1&#46;00&#44; 2&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Risk factors</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Drug addiction &#40;IDU&#41; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">245 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">123 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">122 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>5&#46;36 &#40;4&#46;12&#44; 6&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>2&#46;52 &#40;1&#46;72&#44; 3&#46;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Blood transfusions <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3025 &#40;18&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">662 &#40;24&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2363 &#40;17&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>1&#46;58 &#40;1&#46;43&#44; 1&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">223 &#40;22&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">185 &#40;37&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">254 &#40;21&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;014<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;79 &#40;0&#46;66&#44; 0&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Presence of piercings <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1704 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">372 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1332 &#40;9&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>1&#46;50 &#40;1&#46;32&#44; 1&#46;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">140 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">153 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;001&#46;00 &#40;0&#46;79&#44; 1&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Presence of tattoos <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">160 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;0&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>3&#46;47 &#40;2&#46;48&#44; 4&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5141&#46;21 &#40;0&#46;70&#44; 2&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Comorbidities</span><span class="elsevierStyleItalic"><span class="elsevierStyleBold">n</span></span><span class="elsevierStyleBold">&#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Hepatic manifestations</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cirrhosis <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">992 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">482 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">510 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>5&#46;68 &#40;4&#46;97&#44; 6&#46;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">169 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">257 &#40;22&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1940&#46;87 &#40;0&#46;70&#44; 1&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hepatocellular carcinoma <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">172 &#40;1&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76 &#40;0&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>6&#46;67 &#40;4&#46;87&#44; 9&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3351&#46;24 &#40;0&#46;80&#44; 1&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cardiovascular risk factors</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hypertension <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7698 &#40;47&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1357 &#40;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6341 &#40;46&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>1&#46;19 &#40;1&#46;10&#44; 1&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">448 &#40;44&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">288 &#40;58&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">621 &#40;53&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;66 &#40;0&#46;56&#44; 0&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Diabetes <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6080 &#40;37&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1079 &#40;40&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5001 &#40;36&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>1&#46;17 &#40;1&#46;08&#44; 1&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">343 &#40;34&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">244 &#40;49&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">492 &#40;42&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;65 &#40;0&#46;55&#44; 0&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Dyslipidemia <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7910 &#40;48&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1353 &#40;50&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6557 &#40;48&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;012<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>1&#46;11 &#40;1&#46;02&#44; 1&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">432 &#40;43&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">316 &#40;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">605 &#40;52&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;60 &#40;0&#46;51&#44; 0&#46;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Psychiatric disorders</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Anxiety <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2285 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">390 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1895 &#40;13&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3141&#46;06 &#40;0&#46;94&#44; 1&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">155 &#40;15&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;12&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">173 &#40;14&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3961&#46;11 &#40;0&#46;88&#44; 1&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Depression <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1914 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">342 &#40;12&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1572 &#40;11&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0611&#46;13 &#40;0&#46;99&#44; 1&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">136 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;10&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">153 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4031&#46;10 &#40;0&#46;87&#44; 1&#46;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Dual pathology <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">598 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">156 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">442 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>1&#46;86 &#40;1&#46;53&#44; 2&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>2&#46;25 &#40;1&#46;60&#44; 3&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Others</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Peripheral neuropathy <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1746 &#40;10&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">261 &#40;9&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1485 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1000&#46;89 &#40;0&#46;77&#44; 1&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#40;9&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;7&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">131 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4200&#46;89 &#40;0&#46;67&#44; 1&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Rheumatoid arthritis <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2681 &#40;16&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">357 &#40;13&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2324 &#40;17&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;75 &#40;0&#46;67&#44; 0&#46;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">183 &#40;15&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;003<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;69 &#40;0&#46;54&#44; 0&#46;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hypothyroidism <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1886 &#40;11&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">255 &#40;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1631 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;78 &#40;0&#46;67&#44; 0&#46;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;8&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">129 &#40;11&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1350&#46;81 &#40;0&#46;61&#44; 1&#46;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Non-Hodgkin lymphomas <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">596 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">111 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">485 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1281&#46;18 &#40;0&#46;95&#44; 1&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;005<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>0&#46;54 &#40;0&#46;34&#44; 0&#46;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Co-infections</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>HIV <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">235 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#40;4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">126 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>4&#46;57 &#40;3&#46;49&#44; 5&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;2&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>3&#46;53 &#40;2&#46;32&#44; 5&#46;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3334549.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Welch&#39;s <span class="elsevierStyleItalic">t</span>-test &#40;difference of group means&#41; performed for statistical analysis of age for HCV seropositive vs&#46; seronegative patients&#59; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test &#40;difference in location&#41; performed for statistical analysis of age of HCV active vs&#46; negative viremia&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Statistical differences were considered significant when <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 in two-tailed tests&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Patient characteristics&#46;</p>"
        ]
      ]
      6 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.doc"
          "ficheroTamanyo" => 1168721
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:32 [
            0 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Viral hepatitis and the Global Burden of Disease&#58; a need to regroup"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Cooke"
                            1 => "M&#46; Lemoine"
                            2 => "M&#46; Thursz"
                            3 => "C&#46; Gore"
                            4 => "T&#46; Swan"
                            5 => "A&#46; Kamarulzaman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jvh.12123"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Viral Hepat"
                        "fecha" => "2013"
                        "volumen" => "20"
                        "paginaInicial" => "600"
                        "paginaFinal" => "601"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23910643"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Blach S&#46; Global status update on the HCV prevalence and cascade of care entering 2020&#46; AASLD&#46; Abstract &#35;100&#46; The Liver Meeting&#59; 2021&#59; Digital Experience&#46;"
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; Interim Guidance for Country Validation of Viral Hepatitis Elimination&#46; 2021&#46; 1&#8211;96&#46; Available from&#58; <a target="_blank" href="https://www.who.int/publications/i/item/9789240028395">https&#58;&#47;&#47;www&#46;who&#46;int&#47;publications&#47;i&#47;item&#47;9789240028395</a> &#91;accessed March 2022&#93;&#46;"
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; Global health sector strategy on viral hepatitis 2016&#8211;2021&#46; Towards ending viral hepatitis&#46; 2016&#46; 1&#8211;56&#46; Available from&#58; <a target="_blank" href="https://apps.who.int/iris/handle/10665/246177">https&#58;&#47;&#47;apps&#46;who&#46;int&#47;iris&#47;handle&#47;10665&#47;246177</a> &#91;accessed March 2022&#93;&#46;"
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Progress towards hepatitis C virus elimination in high-income countries&#58; an updated analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Gamkrelidze"
                            1 => "J&#46;-M&#46; Pawlotsky"
                            2 => "J&#46;V&#46; Lazarus"
                            3 => "J&#46;J&#46; Feld"
                            4 => "S&#46; Zeuzem"
                            5 => "Y&#46; Bao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/liv.14779"
                      "Revista" => array:6 [
                        "tituloSerie" => "Liver Int"
                        "fecha" => "2021"
                        "volumen" => "41"
                        "paginaInicial" => "456"
                        "paginaFinal" => "463"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33389788"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hepatitis C virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;P&#46; Manns"
                            1 => "M&#46; Buti"
                            2 => "E&#46; Gane"
                            3 => "J&#46;M&#46; Pawlotsky"
                            4 => "H&#46; Razavi"
                            5 => "N&#46; Terrault"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/nrdp.2017.6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nat Rev Dis Primers"
                        "fecha" => "2017"
                        "volumen" => "3"
                        "paginaInicial" => "17006"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28252637"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A review on extrahepatic manifestations of chronic hepatitis C virus infection and the impact of direct-acting antiviral therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Mazzaro"
                            1 => "L&#46; Quartuccio"
                            2 => "L&#46; Adinolfi"
                            3 => "D&#46; Roccatello"
                            4 => "G&#46; Pozzato"
                            5 => "R&#46; Nevola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/v13112249"
                      "Revista" => array:5 [
                        "tituloSerie" => "Viruses"
                        "fecha" => "2021"
                        "volumen" => "13"
                        "paginaInicial" => "2249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34835054"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of hepatitis B virus&#44; hepatitis C virus&#44; and HIV infection among patients with newly diagnosed cancer form academic and community oncology practices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Ramsey"
                            1 => "J&#46; Unger"
                            2 => "L&#46; Baker"
                            3 => "R&#46; Little"
                            4 => "R&#46; Loomba"
                            5 => "J&#46; Hwang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamaoncol.2018.6437"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Oncol"
                        "fecha" => "2019"
                        "volumen" => "5"
                        "paginaInicial" => "497"
                        "paginaFinal" => "505"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30653226"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Strategy for the elimination of hepatitis C in Cantabria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Crespo"
                            1 => "A&#46; Tejerina Puente"
                            2 => "A&#46; Cuadrado"
                            3 => "S&#46; Llerena"
                            4 => "J&#46; Cabezas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.17235/reed.2020.7108/2020"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Enferm Dig"
                        "fecha" => "2020"
                        "volumen" => "112"
                        "paginaInicial" => "565"
                        "paginaFinal" => "570"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32543873"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening guide for hepatitis C virus infection in Spain&#44; 2020"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Molero Garc&#237;a"
                            1 => "M&#46; Linares Rufo"
                            2 => "F&#46; P&#233;rez Escanilla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.aprim.2020.12.005"
                      "Revista" => array:5 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2021"
                        "volumen" => "53"
                        "paginaInicial" => "101964"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33621820"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Elimination of hepatitis C&#46; Positioning document of the Spanish Association for the Study of the Liver &#40;AEEH&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Crespo"
                            1 => "A&#46; Albillos"
                            2 => "M&#46; Buti"
                            3 => "J&#46;L&#46; Calleja"
                            4 => "J&#46; Garcia-Samaniego"
                            5 => "M&#46; Hernandez-Guerra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.gastrohep.2019.09.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterol Hepatol"
                        "fecha" => "2019"
                        "volumen" => "42"
                        "paginaInicial" => "579"
                        "paginaFinal" => "592"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31594683"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hepatitis C reflex testing in Spain in 2019&#58; a story of success"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Crespo"
                            1 => "P&#46; Lazaro"
                            2 => "A&#46;J&#46; Blasco"
                            3 => "A&#46; Aguilera"
                            4 => "J&#46; Garcia-Samaniego"
                            5 => "J&#46;M&#46; Eiros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eimc.2020.03.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin &#40;Engl Ed&#41;"
                        "fecha" => "2021"
                        "volumen" => "39"
                        "paginaInicial" => "119"
                        "paginaFinal" => "126"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32451150"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Fuentes A&#44; de la Iglesia A&#44; Martinez-Sapina AM&#44; Pereira S&#44; Roc L&#44; de Salazar A&#44; et al&#46; Impacto de la pandemia COVID-19 en el diagn&#243;stico en un solo paso de pacientes en los servicios de microbiolog&#237;a&#46; Abstract &#35;PO-06&#46; 6&#176; Congreso Nacional GEHEP&#59; Virtual&#46; 21-23 September 2021&#46; Available from&#58; <a target="_blank" href="https://www.gehep2021.org/images/site/Programa_GEHEP_.pdf">https&#58;&#47;&#47;www&#46;gehep2021&#46;org&#47;images&#47;site&#47;Programa&#95;GEHEP&#95;&#46;pdf</a> &#91;accessed March 2022&#93;&#46;"
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "virus infection and new treatment strategies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Garcia Deltoro"
                            1 => "C&#46; Ricart Olmos"
                            2 => "C&#46; Hepatitis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2019"
                        "volumen" => "37"
                        "numero" => "S1"
                        "paginaInicial" => "15"
                        "paginaFinal" => "19"
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283819302027"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Natural language processing of clinical notes on chronic diseases&#58; systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Sheikhalishahi"
                            1 => "R&#46; Miotto"
                            2 => "J&#46;T&#46; Dudley"
                            3 => "A&#46; Lavelli"
                            4 => "F&#46; Rinaldi"
                            5 => "V&#46; Osmani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2196/12239"
                      "Revista" => array:6 [
                        "tituloSerie" => "JMIR Med Inform"
                        "fecha" => "2019"
                        "volumen" => "7"
                        "paginaInicial" => "e12239"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31066697"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283820307739"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Opportunities and challenges in developing risk prediction models with electronic health records data&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46;A&#46; Goldstein"
                            1 => "A&#46;M&#46; Navar"
                            2 => "M&#46;J&#46; Pencina"
                            3 => "J&#46;P&#46; Ioannidis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/jamia/ocw042"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Med Inform Assoc"
                        "fecha" => "2017"
                        "volumen" => "24"
                        "paginaInicial" => "198"
                        "paginaFinal" => "208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27189013"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Natural language processing for EHR-based pharmacovigilance&#58; a structured review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Luo"
                            1 => "W&#46;K&#46; Thompson"
                            2 => "T&#46;M&#46; Herr"
                            3 => "Z&#46; Zeng"
                            4 => "M&#46;A&#46; Berendsen"
                            5 => "S&#46;R&#46; Jonnalagadda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40264-017-0558-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Drug Safety"
                        "fecha" => "2017"
                        "volumen" => "40"
                        "paginaInicial" => "1075"
                        "paginaFinal" => "1089"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28643174"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The impact of COVID-19 on patients with asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Izquierdo"
                            1 => "C&#46; Almonacid"
                            2 => "Y&#46; Gonz&#225;lez"
                            3 => "C&#46; Del Rio-Berm&#250;dez"
                            4 => "J&#46; Ancochea"
                            5 => "R&#46; C&#225;rdenas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2003"
                        "volumen" => "2021"
                        "paginaInicial" => "142"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence of gender differences in the diagnosis and management of COVID-19 patients&#58; an analysis of Electronic Health Records using Natural Language Processing and machine learning"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Ancochea"
                            1 => "J&#46;L&#46; Izquierdo"
                            2 => "I&#46;H&#46; Medrano"
                            3 => "A&#46; Porras"
                            4 => "M&#46; Serrano"
                            5 => "S&#46; Lumbreras"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/jwh.2020.8721"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Womens Health &#40;Larchmt&#41;"
                        "fecha" => "2021"
                        "volumen" => "30"
                        "paginaInicial" => "393"
                        "paginaFinal" => "404"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33416429"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283815004443"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics and prognostic factors for intensive care unit admission of patients with COVID-19&#58; retrospective study using machine learning and natural language processing"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Savana COVID-19 Research Group"
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Izquierdo"
                            1 => "J&#46; Ancochea"
                            2 => "J&#46; Soriano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Med Internet Res"
                        "fecha" => "2020"
                        "volumen" => "22"
                        "paginaInicial" => "e2180"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics and prognosis of COVID-19 in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Graziani"
                            1 => "J&#46;B&#46; Soriano"
                            2 => "C&#46; Del Rio-Bermudez"
                            3 => "D&#46; Morena"
                            4 => "T&#46; D&#237;az"
                            5 => "M&#46; Castillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/jcm9103259"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Med"
                        "fecha" => "2020"
                        "volumen" => "9"
                        "paginaInicial" => "3259"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33053774"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing the performance of clinical natural language processing systems&#58; development of an evaluation methodology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Canales"
                            1 => "S&#46; Menke"
                            2 => "S&#46; Marchesseau"
                            3 => "A&#46; D&#8217;Agostino"
                            4 => "C&#46; Del Rio-Bermudez"
                            5 => "M&#46; Taberna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "JMIR Med Inform"
                        "fecha" => "2021"
                        "volumen" => "9"
                        "paginaInicial" => "e20492"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of natural language processing for the identification of crohn disease-related variables in Spanish electronic health records&#58; a validation study for the PREMONITION-CD project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Montoto"
                            1 => "J&#46;P&#46; Gisbert"
                            2 => "I&#46; Guerra"
                            3 => "R&#46; Plaza"
                            4 => "R&#46; Pajares Villarroya"
                            5 => "L&#46; Moreno Almaz&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "JMIR Med Inform"
                        "fecha" => "2022"
                        "volumen" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics and prognostic factors for Crohn&#39;s disease relapses using natural language processing and machine learning&#58; a pilot study"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Premonition-CD Study Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Gomoll&#243;n"
                            1 => "J&#46;P&#46; Gisbert"
                            2 => "I&#46; Guerra"
                            3 => "R&#46; Plaza"
                            4 => "R&#46; Pajares Villarroya"
                            5 => "L&#46; Moreno Almaz&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MEG.0000000000002317"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Gastroenterol Hepatol"
                        "fecha" => "2022"
                        "volumen" => "34"
                        "paginaInicial" => "389"
                        "paginaFinal" => "397"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34882644"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of medical management in Coronary Type 2 Diabetic patients with previous percutaneous coronary intervention in Spain&#58; a retrospective analysis of electronic health records using Natural Language Processing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Gonz&#225;lez-Juanatey"
                            1 => "M&#46; Anguita-S&#225;nchez"
                            2 => "V&#46; Barrios"
                            3 => "I&#46; N&#250;&#241;ez-Gil"
                            4 => "J&#46;J&#46; G&#243;mez-Doblas"
                            5 => "X&#46; Garc&#237;a-Moll"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0263277"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2022"
                        "volumen" => "17"
                        "paginaInicial" => "e0263277"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35143527"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of hepatitis C in the Spanish population&#46; The prevhep study &#40;ethon cohort&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;C&#46; Lavin"
                            1 => "C&#46; Perello"
                            2 => "S&#46; Llerena"
                            3 => "M&#46; Gomez"
                            4 => "M&#46;D&#46; Escudero"
                            5 => "L&#46; Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2017"
                        "volumen" => "66"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Grupo de trabajo del estudio de prevalencia de la infecci&#243;n por hepatitis C en poblaci&#243;n general en Espa&#241;a 2017&#8211;2018&#46; Resultados del 2&#176; Estudio de Seroprevalencia en Espa&#241;a &#40;2017&#8211;2018&#41;&#46; Ministerio de Sanidad&#44; Consumo y Bienestar Social&#46; 2019&#46; Available from&#58; <a target="_blank" href="https://www.sanidad.gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/docs/INFORME_INFECCION_VHC_ESPANA2019.pdf">https&#58;&#47;&#47;www&#46;sanidad&#46;gob&#46;es&#47;ciudadanos&#47;enfLesiones&#47;enfTransmisibles&#47;sida&#47;docs&#47;INFORME&#95;INFECCION&#95;VHC&#95;ESPANA2019&#46;pdf</a> &#91;accessed March 2022&#93;&#46;"
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hepatitis C virus &#40;HCV&#41; micro-elimination in the hospital setting&#58; the results of the HCV Caserta hospital project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Messina"
                            1 => "M&#46; Pisaturo"
                            2 => "L&#46; Alessio"
                            3 => "A&#46; Russo"
                            4 => "E&#46; Tripaldelli"
                            5 => "A&#46; Petruzziello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jiph.2022.04.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect Public Health"
                        "fecha" => "2022"
                        "volumen" => "15"
                        "paginaInicial" => "562"
                        "paginaFinal" => "565"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35461078"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HCV screening&#44; linkage to care&#44; and treatment patterns at different sites across one academic medical center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Calner"
                            1 => "H&#46; Sperring"
                            2 => "G&#46; Ruiz-Mercado"
                            3 => "N&#46;S&#46; Miller"
                            4 => "C&#46; Andry"
                            5 => "L&#46; Battisti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "PLoS ONE"
                        "fecha" => "2019"
                        "volumen" => "14"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and distribution of hepatitis C virus genotypes in Spain during the 2000&#8211;2015 period &#40;the GEHEP 005 study&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Aguilera"
                            1 => "D&#46; Navarro"
                            2 => "F&#46; Rodriguez-Frias"
                            3 => "I&#46; Viciana"
                            4 => "A&#46;M&#46; Martinez-Sapina"
                            5 => "M&#46;J&#46; Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jvh.12700"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Viral Hepat"
                        "fecha" => "2017"
                        "volumen" => "24"
                        "paginaInicial" => "725"
                        "paginaFinal" => "732"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28248445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EASL recommendations on treatment of hepatitis C&#58; final update of the series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;-M&#46; Pawlotsky"
                            1 => "F&#46; Negro"
                            2 => "A&#46; Aghemo"
                            3 => "M&#46; Berenguer"
                            4 => "O&#46; Dalgard"
                            5 => "G&#46; Dusheiko"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jhep.2020.08.018"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2020"
                        "volumen" => "73"
                        "paginaInicial" => "1170"
                        "paginaFinal" => "1218"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32956768"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Llaneras J&#44; Barreira-D&#237;az A&#44; Rando A&#44; Ba&#241;ares J&#44; Meza B&#44; Ruiz L&#44; et al&#46; Hacia un hospital libre de hepatitis C&#58; Resultados del cribado de la hepatitis C en el servicio de urgencias de un hospital de tercer nivel&#46; Abstract &#35;74&#46; 46 Congreso Anual AEEH&#59; Madrid&#44; Spain&#46; 14&#8211;16 June 2021&#46; Available from&#58; <a target="_blank" href="https://static.elsevier.es/congresos/imagenes/132/46_congreso_aeeh.pdf">https&#58;&#47;&#47;static&#46;elsevier&#46;es&#47;congresos&#47;imagenes&#47;132&#47;46&#95;congreso&#95;aeeh&#46;pdf</a> &#91;accessed March 2022&#93;&#46;"
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack701482"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0180" class="elsevierStylePara elsevierViewall">Support to conduct the study was provided by Savana who took part with AbbVie in the study design&#44; research&#44; analysis&#44; data collection&#44; writing and data interpretation&#44; all funded by AbbVie&#46; No honoraria or payments were made for authorship&#46; AbbVie was responsible for review and approval of the publication&#46; The authors thank Sara Paris from AbbVie for taking part in the study design&#44; Francisco Ledesma and Eva Sanz from AbbVie for writing and data interpretation and Miren Taberna MD PhD&#44; David Casadevall MD PhD&#44; V&#237;ctor Fanjul PhD&#44; Hugo Casero&#44; Natalia Polo&#44; Clara L&#46; Oeste PhD from Savana for study design&#44; research&#44; analysis&#44; data collection&#44; and writing within the AbbVie funding&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/24443824/0000004600000007/v2_202311101332/S2444382423001347/v2_202311101332/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "58329"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004600000007/v2_202311101332/S2444382423001347/v2_202311101332/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382423001347?idApp=UINPBA00004N"
]
Article information
ISSN: 24443824
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 3 0 3
2024 October 23 2 25
2024 September 62 9 71
2024 August 17 1 18
2024 July 15 11 26
2024 June 11 1 12
2024 May 7 1 8

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos