July 09, 2025
A national study led by Denver Health researchers and funded by an investigator-initiated grant from the National Institute on Drug Abuse (NIDA) shows that emergency departments (EDs) can be powerful partners in public health—especially when embedded in a system designed to learn and improve.
Published July 9 in “JAMA”, the DETECT Hep C trial found that non-risk-based (nontargeted) hepatitis C screening in EDs identified significantly more new infections than traditional, risk-based screening. The randomized trial included nearly 150,000 patients across three urban hospitals—including Denver Health—and was co-led by Jason Haukoos, MD, MSc, emergency physician (Pictured below, left), and Sarah Rowan, MD, director of the sexual health, HIV, and viral hepatitis division of the Public Health Institute at Denver Health.
“To our knowledge, this is the largest and most comprehensive evaluation of hepatitis C screening strategies in EDs to date,” said Dr. Haukoos. “It’s emblematic of the kind of research we lead here—rigorous, collaborative and deeply rooted in the real-world practice of a learning health system.”
Key findings
The trial compared nontargeted screening, or screening offered to all patients, with targeted screening, or screening offered only to patients with identified risk factors. The nontargeted approach resulted in:
- 154 new HCV diagnoses vs. 115 in the targeted group
- A 34% relative increase in new diagnoses (P = .02)
- Full integration into routine ED workflows using existing clinical staff
“Hepatitis C is curable, but many people don’t know they have it,” said Dr. Rowan. “EDs are often the only access point to care. Embedding screening into routine practice helps us reach those patients.”
Why it matters for a learning health system
Hepatitis C affects an estimated 3–4 million people in the U.S., and many remain undiagnosed. This study demonstrates how pragmatic research embedded in clinical care can drive measurable improvements in detection and equity—hallmarks of Denver Health’s role as an AHRQ-designated learning health system.
The findings support current national guidelines recommending HCV screening and highlight the importance of EDs in helping achieve viral hepatitis elimination goals.
What’s next
While nontargeted HCV screening improved diagnosis, the study also revealed gaps in follow-up: fewer than 1 in 10 patients ultimately achieved documented cure (SVR12) within 18 months. Follow-up studies from the team will explore:
- Linkage to care
- Treatment outcomes
- Cost-effectiveness
The DETECT Hep C trial exemplifies Denver Health’s commitment to closing gaps between evidence and action, especially for underserved populations.
“This is what a learning health system looks like in action,” said Dr. Haukoos.
