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Accuracy of a referral guideline for patients with chronic hepatitis B in primary care to select patients eligible for evaluation by a specialist
  1. Irene K Veldhuijzen1,
  2. Marijke C Mostert1,
  3. Hubert G M Niesters2,
  4. Jan Hendrik Richardus3,
  5. Robert A de Man4
  1. 1Department of Infectious Diseases Control, Municipal Public Health Service Rotterdam Area, Rotterdam, The Netherlands
  2. 2Department of Virology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
  3. 3Department of Public Health, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
  4. 4Department of Gastroenterology and Hepatology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to:
    MsI K Veldhuijzen
    Department of Infectious Disease Control, Municipal Public Health Service Rotterdam Area, PO Box 70032, 3000 LP, Rotterdam, The Netherlands;veldhuijzeni{at}ggd.rotterdam.nl

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Practice guidelines have been developed to select patients with chronic hepatitis B who might benefit from antiviral treatment.1–3 These sophisticated guidelines are directed at specialist care, and include the assessment of serum hepatitis B virus (HBV) DNA. However, most patients with chronic HBV are diagnosed in primary care where HBV DNA is usually not assessed. A simpler, less expensive guideline that can be used at the primary care level to select patients for referral to specialist care can reduce the number of patients referred who, after evaluation by a specialist, are ineligible for treatment. By preventing the referral of ineligible patients, the disappointment that patients with high expectations experience after referral to a specialist is avoided. Furthermore, it reduces the burden on the healthcare system.

A guideline for the referral of patients with chronic HBV …

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