A global action agenda for turning the tide on fatty liver disease

Author:

Lazarus Jeffrey V.123ORCID,Mark Henry E.45ORCID,Allen Alina M.6ORCID,Arab Juan Pablo789ORCID,Carrieri Patrizia10ORCID,Noureddin Mazen11ORCID,Alazawi William12ORCID,Alkhouri Naim13ORCID,Alqahtani Saleh A.14ORCID,Anstee Quentin M.15ORCID,Arrese Marco9,Bataller Ramon16ORCID,Berg Thomas17ORCID,Brennan Paul N.18ORCID,Burra Patrizia19ORCID,Castro-Narro Graciela E.202122ORCID,Cortez-Pinto Helena23ORCID,Cusi Kenneth24ORCID,Dedes Nikos25,Duseja Ajay26ORCID,Francque Sven M.2728ORCID,Gastaldelli Amalia29ORCID,Hagström Hannes30ORCID,Huang Terry T.K.331ORCID,Ivancovsky Wajcman Dana1ORCID,Kautz Achim32,Kopka Christopher J.33ORCID,Krag Aleksander34ORCID,Newsome Philip N.35ORCID,Rinella Mary E.36,Romero Diana37ORCID,Sarin Shiv Kumar38ORCID,Silva Marcelo39,Spearman C. Wendy40ORCID,Terrault Norah A.41ORCID,Tsochatzis Emmanuel A.42ORCID,Valenti Luca4344ORCID,Villota-Rivas Marcela1ORCID,Zelber-Sagi Shira4546,Schattenberg Jörn M.47ORCID,Wong Vincent Wai-Sun48ORCID,Younossi Zobair M.49ORCID,

Affiliation:

1. Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain

2. Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain

3. CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA

4. European Association for the Study of the Liver (EASL), Geneva, Switzerland

5. Independent consultant, Nottingham, UK

6. Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA

7. Department of Medicine, Division of Gastroenterology, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada

8. Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada

9. Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

10. Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France

11. Houston Methodist Hospital, Houston Research Institute, Houston, Texas, USA

12. Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK

13. Fatty Liver Program, Arizona Liver Health, Phoenix, Arizona, USA

14. King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

15. Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK

16. Liver Unit, Hospital Clínic, University of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

17. Department of Medicine II, Division of Hepatology, Leipzig University Medical Center, Leipzig, Germany

18. Division of Hepatology, University of Dundee, Dundee, Scotland, UK

19. Multivisceral Transplant Unit-Gastroenterology, Department of Surgery, Oncology and Gastroenterology at the Padua University Hospital, Padua, Italy

20. Department of Hepatology and Transplant, Hospital Médica Sur, Mexico City, Mexico

21. Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

22. Asociación Latinoamericana para el Estudio del Hígado (ALEH), Santiago, Chile

23. Clinica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal

24. Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, University of Florida, Gainesville, Florida, USA

25. Greek Patients Association, Athens, Greece

26. Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

27. Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium

28. InflaMed Centre of Excellence, Laboratory for Experimental Medicine and Paediatrics, Translational Sciences in Inflammation and Immunology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium

29. Institute of Clinical Physiology, National Research Council, Pisa, Italy

30. Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden

31. CUNY Center for Systems and Community Design and NYU-CUNY Prevention Research Center, New York, New York, USA

32. Kautz 5 gUG, Köln, Germany

33. Independent researcher, Ponte de Lima, Portugal

34. Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark

35. National Institute for Health Research Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK

36. Department of Medicine, University of Chicago, Chicago, Illinois, USA

37. Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA

38. Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India

39. Hepatology and Clinical Research Units, Hospital Universitario Austral, Buenos Aires, Argentina

40. Department of Medicine, Division of Hepatology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

41. Gastrointestinal and Liver Disease Division, University of Southern California, Los Angeles, California, USA

42. UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK

43. Precision Medicine, Biological Resource Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

44. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

45. School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel

46. Department of Gastroenterology, Tel Aviv Medical Centre, Tel Aviv, Israel

47. Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany

48. The Chinese University of Hong Kong, Hong Kong, China

49. Center for Liver Disease, Inova, Falls Church, Virginia, USA

Abstract

Background and Aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach and Results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of “agree” responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% “agree”). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce the prevalence of fatty liver disease and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Hepatology

Reference48 articles.

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