Yeoman A D, Ahmed H, Akbari A, Cullen K, Davies A, Fitzsimmons D, Gao J, Hood K, Nollett C, Vincent A, Williams W, Pembroke Tpi
Gwent Liver Unit, NHS Wales Aneurin Bevan University Health Board, Newport, Wales, NP20 2UB, UK.
Division of Population Medicine, Cardiff University, Cardiff, UK.
NIHR Open Res. 2025 Aug 15;4:57. doi: 10.3310/nihropenres.13663.2. eCollection 2024.
The incidence and severity of liver disease in the United Kingdom have increased over the last 20 years. Many patients present with advanced disease with limited treatment options and subsequently high morbidity and mortality. There was also a significant correlation with deprivation. Strategies that support the earlier detection of liver disease are paramount to reverse this trend. Despite significant progress in terms of novel pathways, the optimal strategy for early detection of liver disease remains unknown. Novel ways to tackle the deprivation gradient and reduce health inequalities are urgently required.
Clinical research has an enormous role to play both in terms of identifying the true scale of this challenge, where current gaps exist, and to identify the optimal early detection strategies and their implementation. We therefore established Liver Research Cymru (LRC) a multi-disciplinary collaboration that seeks to maximise the benefits from our existing data sources and clinical networks and increase the output of hepatology research in Wales.
LRC has developed the first Wales wide research collaborative. We have successfully collaborated with the Secure Anonymised Information Linkage (SAIL) data resource to develop a greater understanding of liver disease burdens through comprehensive analysis of primary and secondary care data. We are now using this information to evaluate the effectiveness of local early detection pathways and to identify the scale of delays in diagnosis with a view to addressing this important care gap.
LRC has successfully brought together patients. Hepatologists and population/primary care academics to better understand current discrepancies in the early diagnosis of liver disease in Wales. In addition, it has laid a foundation for future research work based both on our preliminary findings and allowed us to collaborate with other more established liver disease research groups.
在过去20年中，英国肝脏疾病的发病率和严重程度有所上升。许多患者就诊时已处于疾病晚期，治疗选择有限，随后出现高发病率和高死亡率。这也与贫困存在显著相关性。支持肝病早期检测的策略对于扭转这一趋势至关重要。尽管在新途径方面取得了重大进展，但肝病早期检测的最佳策略仍不明确。迫切需要新的方法来应对贫困梯度并减少健康不平等。
临床研究在确定这一挑战的真实规模、当前存在的差距以及确定最佳早期检测策略及其实施方面都发挥着巨大作用。因此，我们成立了威尔士肝脏研究组织（LRC），这是一个多学科合作组织，旨在从我们现有的数据源和临床网络中获取最大利益，并增加威尔士肝脏病学研究产出。
LRC建立了首个覆盖威尔士的研究合作项目。我们已成功与安全匿名信息链接（SAIL）数据资源合作，通过对初级和二级医疗数据的全面分析，更深入地了解肝脏疾病负担。我们现在正利用这些信息评估当地早期检测途径的有效性，并确定诊断延迟的规模，以弥补这一重要的医疗差距。
LRC成功地将患者、肝病专家以及人群/初级医疗学者聚集在一起，以更好地理解威尔士目前肝病早期诊断中的差异。此外，它基于我们的初步研究结果为未来的研究工作奠定了基础，并使我们能够与其他更成熟的肝病研究小组合作。
