A global research priority agenda to advance public health responses to fatty liver disease.
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Lazarus Jeffrey V, Mark 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, Healthy Livers, Healthy Lives Collaborators
Аннотация
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.