TY - JOUR
T1 - A global research priority agenda to advance public health responses to fatty liver disease
AU - Lazarus, Jeffrey V.
AU - Mark, Henry E.
AU - Allen, Alina M.
AU - Arab, Juan Pablo
AU - Carrieri, Patrizia
AU - Noureddin, Mazen
AU - Alazawi, William
AU - Alkhouri, Naim
AU - Alqahtani, Saleh A.
AU - Arrese, Marco
AU - Bataller, Ramon
AU - Berg, Thomas
AU - Brennan, Paul N.
AU - Burra, Patrizia
AU - Castro-Narro, Graciela E.
AU - Cortez-Pinto, Helena
AU - Cusi, Kenneth
AU - Dedes, Nikos
AU - Duseja, Ajay
AU - Francque, Sven M.
AU - Hagström, Hannes
AU - Huang, Terry T.K.
AU - Wajcman, Dana Ivancovsky
AU - Kautz, Achim
AU - Kopka, Christopher J.
AU - Krag, Aleksander
AU - Miller, Veronica
AU - Newsome, Philip N.
AU - Rinella, Mary E.
AU - Romero, Diana
AU - Sarin, Shiv Kumar
AU - Silva, Marcelo
AU - Spearman, C. Wendy
AU - Tsochatzis, Emmanuel A.
AU - Valenti, Luca
AU - Villota-Rivas, Marcela
AU - Zelber-Sagi, Shira
AU - Schattenberg, Jörn M.
AU - Wong, Vincent Wai Sun
AU - Younossi, Zobair M.
AU - Huang, Terry T.K.
AU - Aberg, Fredrik
AU - Adams, Leon
AU - Al-Naamani, Khalid
AU - Albadawy, Reda M.
AU - Alexa, Zinaida
AU - Allison, Michael
AU - Alnaser, Faisal A.
AU - Alswat, Khalid
AU - Alvares-da-Silva, Mario Reis
AU - Shibolet, Oren
N1 - Publisher Copyright: © 2023 The Author(s)
PY - 2023/9
Y1 - 2023/9
N2 - 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.
AB - 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.
KW - Delphi method
KW - Global health
KW - NAFLD/NASH
KW - Non-communicable disease (NCD)
KW - Steatotic liver disease
UR - http://www.scopus.com/inward/record.url?scp=85165924387&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jhep.2023.04.035
DO - https://doi.org/10.1016/j.jhep.2023.04.035
M3 - Article
C2 - 37353401
SN - 0168-8278
VL - 79
SP - 618
EP - 634
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 3
ER -