A Global Survey of Physicians Knowledge About Non-alcoholic Fatty Liver Disease

Younossi ZM 1 , Ong JP 2 , Takahashi H 3 , Yilmaz Y 4 , Eguchi Y 5 , El Kassas M 6 Show all authors , Buti M 7 , Diago M 8 , Zheng MH 9 , Fan JG 10 , Yu ML 11 , Wong VW 12 , Alswat K 13 , Chan WK 14 , Mendez-Sanchez N 15 , Burra P 16 , Bugianesi E 17 , Duseja AK 18 , George J 19 , Papatheodoridis GV 20 , Saeed H 21 , Castera L 22 , Arrese M 23 , Kugelmas M 24 , Romero-Gomez M 25 , Alqahtani S 26 , Ziayee M 27 , Lam B 28 , Younossi I 27 , Racila A 28 , Henry L 27 , Stepanova M 27 , Global NASH Council

Affiliations 

  • 1 Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; Inova Medicine, Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA. Electronic address: [email protected]
  • 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, Marmara University, 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, the Vall d'Hebron University Hospital and CIBER-EHD del instituto Carlos III, Barcelona, Spain
  • 8 Departamento de Patología Digestiva, Consorcio Hospital General Universitario de Valencia, Spain
  • 9 NAFLD 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, 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 & 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 and University of Sydney, Australia
  • 20 National and Kapodistrian University of Athens, Greece
  • 21 Department of Medicine, Aga Khan University, Karachi, Pakistan
  • 22 Dept 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, CO, United States
  • 25 Digestive Diseases Department. Virgen del Rocío University Hospital. Institute of Biomedicine of Seville. University of Seville. Spain
  • 26 King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Center for Outcomes Research in Liver Disease, Washington DC, United States
  • 27 Center for Outcomes Research in Liver Disease, Washington DC, United States
  • 28 Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; Inova Medicine, Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA
Clin Gastroenterol Hepatol, 2021 Jul 03.
PMID: 34229038 DOI: 10.1016/j.cgh.2021.06.048

Abstract

BACKGROUND & AIMS: Despite rapidly increasing NAFLD prevalence, providers' knowledge may be limited. We assessed NAFLD knowledge and associated factors among physicians of different specialties globally.

APPROACH & RESULTS: NAFLD knowledge surveys containing 54 and 59 questions covering three 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 (GBD) super-regions. Over 24 months, 2202 surveys were completed (488 hepatologists, 758 GEs, 148 ENDOs, and 808 PCPs; 50% High-Income GBD super-region, 27% from North Africa and Middle East, 12% Southeast Asia, and 5% South Asian and Latin America). Hepatologists saw the greatest number of NAFLD patients annually: median (IQR) 150 (60-300) vs. 100 (35-200) for GEs, 100 (30-200) for ENDOs, and 10 (4-50) for PCPs (all p<0.0001). The primary sources of NAFLD knowledge acquisition for hepatologists were international conferences (33% vs. 8-26%) and practice guidelines for others (39-44%). 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%, Treatment 61% vs. 58% (p<0.0001) and ENDOs scores were higher than PCPs: Epidemiology 70% vs. 60%, Diagnostics 71% vs. 64%, Treatment 79% vs. 68% (p<0.0001). Being a hepatologist or ENDO was associated with higher knowledge scores than GE or PCP, respectively (p<0.05). Higher NAFLD knowledge scores were independently associated with greater number of NAFLD patients seen (p<0.05).

CONCLUSION: Despite the growing burden of NAFLD, significant knowledge gap remains for identification, diagnosis and management of NAFLD.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

Similar publications