A global research priority agenda to advance public health responses to fatty liver disease.
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Author
Lazarus, Jeffrey VMark, Henry E
Allen, Alina M
Arab, Juan Pablo
Carrieri, Patrizia
Noureddin, Mazen
Alazawi, William
Alkhouri, Naim
Alqahtani, Saleh A
Arrese, Marco
Bataller, Ramon
Berg, Thomas
Brennan, Paul N
Burra, Patrizia
Castro-Narro, Graciela E
Cortez-Pinto, Helena
Cusi, Kenneth
Dedes, Nikos
Duseja, Ajay
Francque, Sven M
Hagström, Hannes
Huang, Terry T-K
Wajcman, Dana Ivancovsky
Kautz, Achim
Kopka, Christopher J
Krag, Aleksander
Miller, Veronica
Newsome, Philip N
Rinella, Mary E
Romero, Diana
Sarin, Shiv Kumar
Silva, Marcelo
Spearman, C Wendy
Tsochatzis, Emmanuel A
Valenti, Luca
Villota-Rivas, Marcela
Zelber-Sagi, Shira
Schattenberg, Jörn M
Wong, Vincent Wai-Sun
Younossi, Zobair M
Publication date
2023-06-20Subject
Gastroenterology
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Abstract Background & aims: An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community. Methods: Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy. Results: The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of 'agree' responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement ('agree' + 'somewhat agree'); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% 'agree'), 13 priorities had <80% 'agree', with greater reliance on 'somewhat agree' to achieve >90% combined agreement. Conclusions: Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community's efforts to advance and accelerate responses to this widespread and fast-growing public health threat. Impact and implications: An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat. Keywords: Delphi method; Global health; NAFLD/NASH; Non-communicable disease (NCD); Steatotic liver disease.Citation
Lazarus, J. V., Mark, H. E., Allen, A. M., Arab, J. P., Carrieri, P., Noureddin, M., Alazawi, W., Alkhouri, N., Alqahtani, S. A., Arrese, M., Bataller, R., Berg, T., Brennan, P. N., Burra, P., Castro-Narro, G. E., Cortez-Pinto, H., Cusi, K., Dedes, N., Duseja, A., Francque, S. M., … Healthy Livers, Healthy Lives Collaborators (2023). A global research priority agenda to advance public health responses to fatty liver disease. Journal of hepatology, 79(3), 618–634. https://doi.org/10.1016/j.jhep.2023.04.035Type
ArticleAdditional Links
http://www.sciencedirect.com/science/journal/01688278PMID
37353401Journal
Journal of HepatologyPublisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.jhep.2023.04.035