Lazarus Jeffrey V, Palayew Adam, Carrieri Patrizia, Ekstedt Mattias, Marchesini Giulio, Novak Katja, Ratziu Vlad, Romero-Gómez Manuel, Tacke Frank, Zelber-Sagi Shira, Cortez-Pinto Helena, Anstee Quentin M
Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
McGill University Department of Epidemiology, Biostatistics, and Occupational Health, Montreal, Canada.
JHEP Rep. 2021 Jan 21;3(2):100234. doi: 10.1016/j.jhepr.2021.100234. eCollection 2021 Apr.
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD), which is closely associated with obesity, metabolic syndrome, and diabetes, is a highly prevalent emerging condition that can be optimally managed through a multidisciplinary patient-centred approach. National preparedness to address NAFLD is essential to ensure that health systems can deliver effective care. We present a NAFLD Preparedness Index for Europe.
In June 2019, data were extracted by expert groups from 29 countries to complete a 41-item questionnaire about NAFLD. Questions were classified into 4 categories: policies/civil society (9 questions), guidelines (16 questions), epidemiology (4 questions), and care management (12 questions). Based on the responses, national preparedness for each indicator was classified into low, middle, or high-levels. We then applied a multiple correspondence analysis to obtain a standardised preparedness score for each country ranging from 0 to 100.
The analysis estimated a summary factor that explained 71.3% of the variation in the dataset. No countries were found to have yet attained a high-level of preparedness. Currently, the UK (75.5) scored best, although falling within the mid-level preparedness band, followed by Spain (56.2), and Denmark (43.4), whereas Luxembourg and Ireland were the lowest scoring countries with a score of 4.9. Only Spain scored highly in the epidemiology indicator category, whereas the UK was the only country that scored highly for care management.
The NAFLD Preparedness Index indicates substantial variation between countries' readiness to address NAFLD. Notably, even those countries that score relatively highly exhibit deficiencies in key domains, suggesting that structural changes are needed to optimise NAFLD management and ensure effective public health approaches are in place.
Non-alcoholic fatty liver disease (NAFLD), which is closely associated with obesity, metabolic syndrome, and diabetes, is a highly prevalent condition that can be optimally managed through a multidisciplinary patient-centred approach. National preparedness to address NAFLD is essential to allow for effective public health measures aimed at preventing disease while also ensuring that health systems can deliver effective care to affected populations. This study defined preparedness as having adequate policies and civil society engagement, guidelines, epidemiology, and care management. NAFLD preparedness was found to be deficient in all 29 countries studied, with great variation among the countries and the 4 categories studied.
非酒精性脂肪性肝病（NAFLD）与肥胖、代谢综合征和糖尿病密切相关，是一种高度流行的新兴疾病，可通过以患者为中心的多学科方法进行最佳管理。国家应对NAFLD的准备工作对于确保卫生系统能够提供有效治疗至关重要。我们提出了一个欧洲NAFLD准备指数。
2019年6月，专家组从29个国家提取数据，以完成一份关于NAFLD的41项问卷。问题分为4类：政策/民间社会（9个问题）、指南（16个问题）、流行病学（4个问题）和护理管理（12个问题）。根据回答，将每个指标的国家准备情况分为低、中、高三个级别。然后，我们应用多重对应分析来获得每个国家从0到100的标准化准备得分。
分析估计了一个汇总因子，该因子解释了数据集中71.3%的变异。未发现有国家达到高级别的准备状态。目前，英国（75.5）得分最高，尽管仍处于中级准备范围，其次是西班牙（56.2）和丹麦（43.4），而卢森堡和爱尔兰是得分最低的国家，得分为4.9。只有西班牙在流行病学指标类别中得分较高，而英国是唯一在护理管理方面得分较高的国家。
NAFLD准备指数表明各国应对NAFLD的准备程度存在很大差异。值得注意的是，即使是那些得分相对较高的国家在关键领域也存在不足，这表明需要进行结构调整以优化NAFLD管理并确保有效的公共卫生方法到位。
非酒精性脂肪性肝病（NAFLD）与肥胖、代谢综合征和糖尿病密切相关，是一种高度流行的疾病，可通过以患者为中心的多学科方法进行最佳管理。国家应对NAFLD的准备工作对于采取有效的公共卫生措施以预防疾病并确保卫生系统能够为受影响人群提供有效治疗至关重要。本研究将准备情况定义为具备适当的政策、民间社会参与、指南、流行病学和护理管理。研究发现，在所有29个研究国家中，NAFLD准备情况均存在不足，在所研究的国家和4个类别中差异很大。
