Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
Hepatology. 2024 Feb 1;79(2):502-523. doi: 10.1097/HEP.0000000000000545. Epub 2023 Aug 4.
Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care.
We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of "agree" responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% "agree"). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance.
This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce the prevalence of fatty liver disease and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.
由于其极高的患病率以及相关发病率和死亡率，脂肪肝疾病是一个主要的公共卫生威胁。迫切需要有针对性的、专门的干预措施来针对疾病预防、治疗和护理。
我们为全球脂肪肝疾病实践社区制定了一个协调一致、重点突出的行动计划。通过两轮德尔菲法，一个大型小组（第一轮 n = 344，第二轮 n = 288）使用 Qualtrics XM 审查了行动计划，使用 4 分李克特量表表示同意，并提供书面反馈。在两轮之间对优先事项进行了修订，在第二轮中，小组成员还对 6 个领域内的优先事项进行了排名：流行病学、治疗和护理、护理模式、教育和意识、患者和社区观点以及领导力和公共卫生政策。共识性脂肪肝疾病行动计划包括 29 项优先事项。在第二轮中，“同意”的平均百分比为 82.4%，所有个别优先事项的同意率都超过了超级多数（> 66.7%“同意”）。排名最高的行动优先事项包括肝病专家和初级保健医生在早期诊断方面的合作、采取行动满足患有多种合并症的人的需求，以及将脂肪肝疾病纳入相关非传染性疾病战略和指导。
由护理提供者、临床研究人员以及公共卫生和政策专家共同制定的、以共识为导向的多学科脂肪肝疾病行动计划为降低脂肪肝疾病的患病率和改善健康结果提供了一条途径。为了实施这一议程，需要在全球、区域和国家各级做出协调一致的努力。
