Fouad Yasser, Elwakil Reda, Elsahhar Medhat, Said Ebada, Bazeed Shamardan, Ali Gomaa Ahmed, Hashim Almoutaz, Kamal Enas, Mehrez Mai, Attia Dina
Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt.
Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Egypt.
Liver Int. 2021 Feb;41(2):255-260. doi: 10.1111/liv.14739. Epub 2020 Dec 2.
Debates are inevitable in science and could be a powerful tool for addressing controversial topics as it promotes critical thinking and inspires individuals to consider alternate viewpoints. However, debates can help only to identify the issues that need to be clarified to address this question, but it can never help resolve the controversy itself. In the era of evidence-based medicine, the need for an evidence-based debate is mandatory. Polarising opinions and major debate have recently arisen in hepatology on the nomenclature and diagnostic criteria for fatty liver disease associated with metabolic dysfunction (non alcoholic fatty liver disease [NAFLD]-metabolic (dysfunction) associated fatty liver disease [MAFLD] debate). The aim of this viewpoint is to suggest a way to settle the debate through evidence. Descriptive review using PubMed to identify literature on the evidence and eminence-based medicine and studies comparing MAFLD and NAFLD criteria. The emerging studies comparing the performance of diagnostic criteria of NAFLD and MAFLD represent the dawn of a new era for reframing the ongoing debate by acquisition of the mandatory evidence that will both resolve the debate and lead to novel avenues of research. In conclusion, the time has come to hold debate and focus on gathering and building the evidence to settle it. It does not matter who wins the debate and once there is robust evidence, we should all follow it wherever it leads.
科学领域的争论不可避免,它可以成为解决争议性话题的有力工具,因为它能促进批判性思维,并激发人们考虑不同观点。然而,争论只能帮助识别为解决该问题需要澄清的问题,却永远无法解决争议本身。在循证医学时代,基于证据进行争论是必不可少的。最近,肝病学领域就与代谢功能障碍相关的脂肪性肝病(非酒精性脂肪性肝病[NAFLD] - 代谢(功能障碍)相关脂肪性肝病[MAFLD]之争)的命名和诊断标准出现了两极分化的观点和重大争论。本文观点旨在提出一种通过证据解决争论的方法。使用PubMed进行描述性综述,以识别关于证据和基于卓越性的医学的文献,以及比较MAFLD和NAFLD标准的研究。比较NAFLD和MAFLD诊断标准性能的新兴研究,代表了一个新时代的曙光,即通过获取既能解决争论又能引领新研究途径的强制性证据,来重新构建正在进行的争论。总之,现在是时候展开争论,并专注于收集和积累证据以解决争论了。争论谁胜谁负并不重要,一旦有了确凿的证据,我们都应该遵循它的指引。