Allen Alina M, Hoovler Anthony R, Articolo Amy, Fisher Travis, Noureddin Mazen, Dieterich Douglas
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Liver Health, Novo Nordisk Inc., Plainsboro, NJ, USA.
Adv Med Educ Pract. 2025 May 5;16:729-748. doi: 10.2147/AMEP.S491271. eCollection 2025.
Metabolic dysfunction-associated steatotic liver disease (MASLD) and its inflammatory subtype, metabolic dysfunction-associated steatohepatitis (MASH), are associated with cardiometabolic risk factors, including obesity and type 2 diabetes. The prevalence of both conditions is rising rapidly and is underdiagnosed (<5%). We aimed to gather qualitative and quantitative insights from program leaders in US medical education training on their experience with MASH-related training and education.
A cross-sectional study consisting of a quantitative survey and qualitative discussions with individuals in primary care (internal medicine and family medicine) and specialty programs (hepatology, gastroenterology, and endocrinology) were held from February 21 to August 28, 2023. Descriptive statistics were used for data analysis.
A total of 190 leaders participated in the online survey and 11 leaders joined the focus groups. Almost all respondents reported that MASLD (96%) and MASH (92%) were included in their program's curricula. However, many believed that little time was devoted to discussing MASH in their program. Most respondents agreed that MASH is extremely underdiagnosed. Program leaders agreed that the interconnectedness of MASH with other cardiometabolic conditions necessitates instruction time on MASH beyond that of its dedicated curriculum time. All participants believed that emergence of regulatory-approved drugs for MASH will drive a decision to increase the time allotted for MASH in the curriculum.
Although program leaders agreed that MASH has an important place in medical education curricula, the relative paucity of treatment options reduces its coverage in training, thereby limiting healthcare practitioners' understanding of MASH.
代谢功能障碍相关脂肪性肝病（MASLD）及其炎症亚型代谢功能障碍相关脂肪性肝炎（MASH）与包括肥胖症和2型糖尿病在内的心血管代谢危险因素相关。这两种疾病的患病率正在迅速上升，且诊断不足（<5%）。我们旨在从美国医学教育培训项目负责人那里收集关于他们在MASH相关培训和教育方面经验的定性和定量见解。
2023年2月21日至8月28日进行了一项横断面研究，包括对初级保健（内科和家庭医学）以及专科项目（肝病学、胃肠病学和内分泌学）的人员进行定量调查和定性讨论。采用描述性统计进行数据分析。
共有190名负责人参与了在线调查，11名负责人参加了焦点小组。几乎所有受访者都报告称，MASLD（96%）和MASH（92%）被纳入了他们项目的课程中。然而，许多人认为他们的项目中用于讨论MASH的时间很少。大多数受访者一致认为MASH的诊断严重不足。项目负责人一致认为，MASH与其他心血管代谢疾病的相互关联性使得在其专门课程时间之外，还需要安排关于MASH的教学时间。所有参与者都认为，针对MASH的监管批准药物的出现将促使决定增加课程中分配给MASH的时间。
尽管项目负责人一致认为MASH在医学教育课程中占有重要地位，但治疗选择相对较少，这减少了其在培训中的覆盖范围，从而限制了医护人员对MASH的了解。
