# The Determining Effective Testing in Emergency Departments and Care Coordination on Treatment Outcomes (DETECT) for HCV Trial

> **NIH NIH R01** · DENVER HEALTH AND HOSPITAL AUTHORITY · 2021 · $550,678

## Abstract

PROJECT SUMMARY
Identification of undiagnosed hepatitis C virus (HCV) infection and effective linkage-to-care is a critical public
health priority. In the United States, over 3 million individuals are chronically infected with HCV, of which the
majority (>50%) remain undiagnosed. The Centers for Disease Control and Prevention and U.S. Preventive
Services Task Force recommend screening all individuals born from 1945 through 1965 (i.e., “birth cohort”)
and non-birth cohort individuals with known risks for HCV infection (e.g., people who inject drugs) to increase
diagnoses, treatment, and cure, while reversing the increasing incidence, morbidity, mortality, and healthcare
costs associated with HCV infection. Emergency departments (EDs) have been a major focus of infectious
diseases screening, including human immunodeficiency virus (HIV) infection and, more recently, HCV
infection. This focus is prompted by the fact that over 135 million ED visits occur annually in the United States,
EDs serve large proportions of underserved and at-risk patients, and EDs are common sites of missed
diagnostic opportunities. Our research team has pioneered investigations in ED-based HIV and HCV screening
since 2004 with the overarching goal of determining the most effective and efficient methods of screening
among high-risk populations in EDs. To build on our work, we propose the following specific aims: (1) to
compare the effectiveness of non-risk-based (nontargeted) and risk-based (targeted) HCV screening when
integrated into urban EDs; (2) to compare the effectiveness of linkage navigation plus clinician referral versus
clinician referral alone for HCV-infected patients identified in EDs; and (3) to estimate programmatic costs and
project long-term outcomes and cost effectiveness of ED-based HCV screening and linkage to care. In doing
so, we will perform the following studies: (a) a multi-center prospective pragmatic randomized effectiveness
trial to test whether nontargeted HCV screening is significantly associated with newly-diagnosed HCV infection
when compared to targeted HCV screening; (b) a distinct single-center prospective pragmatic randomized
effectiveness trial to test whether linkage navigation significantly increases the proportion of newly diagnosed
patients who complete primary care visits for HCV infection and progress through the HCV Care Continuum
when compared to standard clinician referral; (c) a nested prospective cohort study using time-motion methods
and actual trial expenses to estimate direct costs per newly-diagnosed HCV infection for each screening
method; and (d) an analysis with results from both clinical trials to parameterize a Monte Carlo transition-state
simulation model of HCV screening, treatment, and disease progression to test whether nontargeted HCV
screening coupled with linkage navigation will yield the best outcomes and be cost effective. This project will
be the largest and most comprehensive evaluation of HCV screening in E...

## Key facts

- **NIH application ID:** 10071153
- **Project number:** 5R01DA042982-04
- **Recipient organization:** DENVER HEALTH AND HOSPITAL AUTHORITY
- **Principal Investigator:** JASON HAUKOOS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $550,678
- **Award type:** 5
- **Project period:** 2018-03-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10071153

## Citation

> US National Institutes of Health, RePORTER application 10071153, The Determining Effective Testing in Emergency Departments and Care Coordination on Treatment Outcomes (DETECT) for HCV Trial (5R01DA042982-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10071153. Licensed CC0.

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