Zobair M Younossi1, Janus P Ong2, Hirokazu Takahashi3, Yusuf Yilmaz4, Yuichiro Eguc Hi5, Mohamed El Kassas6, Maria Buti7, Moisés Diago8, Ming-Hua Zheng9, Jian-Gao Fan10, Ming-Lung Yu11, Vincent Wai-Sun Wong12, Khalid Alswat13, Wah-Kheong Chan14, Nahum Mendez-Sanchez15, Patrizia Burra16, Elisabetta Bugianesi17, Ajay K Duseja18, Jacob George19, George V Papatheodoridis20, Hamid Saeed21, Laurent Castera22, Marco Arrese23, Marcelo Kugelmas24, Manuel Romero-Gomez25, Saleh Alqahtani26, Mariam Ziayee27, Brian Lam28, Issah Younossi27, Andrei Racila28, Linda Henry27, Maria Stepanova27. 1. Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia; Inova Medicine, Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia. Electronic address: Zobair.Younossi@inova.org. 2. University of the Philippines, College of Medicine, Manila, Philippines. 3. Liver Center, Saga University Hospital, Saga, Japan. 4. Department of Gastroenterology, School of Medicine, Istanbul, Turkey; Liver Research Unit, Institute of Gastroenterology, Marmara University, Istanbul, Turkey. 5. Locomedical General Institute, Locomedical Medical Cooperation, Ogi, Saga, Japan. 6. Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt. 7. Liver Unit, Vall d'Hebron University Hospital, CIBER-EHD del Instituto Carlos III, Barcelona, Spain. 8. Departamento de Patología Digestiva, Consorcio Hospital General Universitario de Valencia, Valencia, Spain. 9. Nonalcoholic Fatty Liver Disease Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 10. Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiatong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China. 11. Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 12. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong. 13. Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 14. Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 15. Liver Research Unit, Medica Sur Clinic and Foundation, National Autonomous University of Mexico, Mexico City, Mexico. 16. Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy. 17. Division of Gastroenterology, Department of Medical Sciences, University of Torino, Torino, Italy. 18. Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 19. Storr Liver Centre, Westmead Hospital, University of Sydney, Sydney, Australia. 20. National and Kapodistrian University of Athens, Athens, Greece. 21. Department of Medicine, Aga Khan University, Karachi, Pakistan. 22. Department of Hepatology, Hôpital Beaujon, University of Paris, Clichy, France. 23. Departmento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile. 24. South Denver Gastroenterology, PC, Denver, Colorado. 25. Digestive Diseases Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville, University of Seville, Seville, Spain. 26. King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Center for Outcomes Research in Liver Disease, Washington, District of Columbia. 27. Center for Outcomes Research in Liver Disease, Washington, District of Columbia. 28. Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia; Inova Medicine, Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia.
Abstract
BACKGROUND & AIMS: Despite rapidly increasing nonalcoholic fatty liver disease (NAFLD) prevalence, providers' knowledge may be limited. We assessed NAFLD knowledge and associated factors among physicians of different specialties globally. METHODS: NAFLD knowledge surveys containing 54 and 59 questions covering 3 domains (epidemiology/pathogenesis, diagnostics, and treatment) were completed electronically by hepatologists, gastroenterologists (GEs), endocrinologists (ENDOs), and primary care physicians (PCPs) from 40 countries comprising 5 Global Burden of Disease super-regions. Over 24 months, 2202 surveys were completed (488 hepatologists, 758 GEs, 148 ENDOs, and 808 PCPs; 50% high-income Global Burden of Disease super-region, 27% from North Africa and Middle East, 12% Southeast Asia, and 5% South Asian and Latin America). RESULTS: Hepatologists saw the greatest number of NAFLD patients annually: median 150 (interquartile range, 60-300) vs 100 (interquartile range, 35-200) for GEs, 100 (interquartile range, 30-200) for ENDOs, and 10 (interquartile range, 4-50) for PCPs (all P < .0001). The primary sources of NAFLD knowledge acquisition for hepatologists were international conferences (33% vs 8%-26%) and practice guidelines for others (39%-44%). The Internet was the second most common source of NAFLD knowledge for PCPs (28%). NAFLD knowledge scores were higher for hepatologists than GEs: epidemiology, 62% vs 53%; diagnostics, 80% vs 73%; and treatment, 61% vs 58% (P < .0001), and ENDOs scores were higher than PCPs: epidemiology, 70% vs 60%; diagnostics, 71% vs 64%; and treatment, 79% vs 68% (P < .0001). Being a hepatologist or ENDO was associated with higher knowledge scores than a GE or PCP, respectively (P < .05). Higher NAFLD knowledge scores were associated independently with a greater number of NAFLD patients seen (P < .05). CONCLUSIONS: Despite the growing burden of NAFLD, a significant knowledge gap remains for the identification, diagnosis, and management of NAFLD.
BACKGROUND & AIMS: Despite rapidly increasing nonalcoholic fatty liver disease (NAFLD) prevalence, providers' knowledge may be limited. We assessed NAFLD knowledge and associated factors among physicians of different specialties globally. METHODS: NAFLD knowledge surveys containing 54 and 59 questions covering 3 domains (epidemiology/pathogenesis, diagnostics, and treatment) were completed electronically by hepatologists, gastroenterologists (GEs), endocrinologists (ENDOs), and primary care physicians (PCPs) from 40 countries comprising 5 Global Burden of Disease super-regions. Over 24 months, 2202 surveys were completed (488 hepatologists, 758 GEs, 148 ENDOs, and 808 PCPs; 50% high-income Global Burden of Disease super-region, 27% from North Africa and Middle East, 12% Southeast Asia, and 5% South Asian and Latin America). RESULTS: Hepatologists saw the greatest number of NAFLD patients annually: median 150 (interquartile range, 60-300) vs 100 (interquartile range, 35-200) for GEs, 100 (interquartile range, 30-200) for ENDOs, and 10 (interquartile range, 4-50) for PCPs (all P < .0001). The primary sources of NAFLD knowledge acquisition for hepatologists were international conferences (33% vs 8%-26%) and practice guidelines for others (39%-44%). The Internet was the second most common source of NAFLD knowledge for PCPs (28%). NAFLD knowledge scores were higher for hepatologists than GEs: epidemiology, 62% vs 53%; diagnostics, 80% vs 73%; and treatment, 61% vs 58% (P < .0001), and ENDOs scores were higher than PCPs: epidemiology, 70% vs 60%; diagnostics, 71% vs 64%; and treatment, 79% vs 68% (P < .0001). Being a hepatologist or ENDO was associated with higher knowledge scores than a GE or PCP, respectively (P < .05). Higher NAFLD knowledge scores were associated independently with a greater number of NAFLD patients seen (P < .05). CONCLUSIONS: Despite the growing burden of NAFLD, a significant knowledge gap remains for the identification, diagnosis, and management of NAFLD.
Authors: Zobair M Younossi; Sean Felix; Thomas Jeffers; Elena Younossi; Fatema Nader; Huong Pham; Arian Afendy; Rebecca Cable; Andrei Racila; Zahra Younoszai; Brian P Lam; Pegah Golabi; Linda Henry; Maria Stepanova Journal: JAMA Netw Open Date: 2021-09-01
Authors: Lucy Gracen; Kelly L Hayward; Melanie Aikebuse; Suzanne Williams; Anthony Russell; James O'Beirne; Elizabeth E Powell; Patricia C Valery Journal: Diabet Med Date: 2022-02-07 Impact factor: 4.213