Quality standards for the management of non-alcoholic fatty liver disease (NAFLD): consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology NAFLD Special Interest Group.
Quality standards for the management of non-alcoholic fatty liver disease (NAFLD): consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology NAFLD Special Interest Group.
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DOI：
10.1016/s2468-1253(22)00061-9
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发表时间：
2022-08
期刊：
影响因子：
--
通讯作者：
Alazawi W
中科院分区：
文献类型：
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作者：
McPherson S;Armstrong MJ;Cobbold JF;Corless L;Anstee QM;Aspinall RJ;Barclay ST;Brennan PN;Cacciottolo TM;Goldin RD;Hallsworth K;Hebditch V;Jack K;Jarvis H;Johnson J;Li W;Mansour D;McCallum M;Mukhopadhya A;Parker R;Ross V;Rowe IA;Srivastava A;Thiagarajan P;Thompson AI;Tomlinson J;Tsochatzis EA;Yeoman A;Alazawi W
非酒精相关性脂肪肝 (NAFLD) 很常见，影响约 25% 的总人口。 NAFLD 调查和管理的证据基础庞大且不断增长，但目前支持服务发展和护理提供的实际指导很少。为了解决这个问题，我们针对 NAFLD 的管理制定了一系列基于证据的质量标准建议，旨在推动患者护理的改善。来自英国肝脏研究协会 (BASL) 和英国胃肠病学会 (BSG) NAFLD 特别兴趣小组 (SIG) 的多学科专家组提出的建议涵盖： 1. 在胃肠病学或肝脏诊所之前对 NAFLD 患者或有 NAFLD 风险的患者进行管理； 2. 二级护理的评估和调查，以及 3. 二级护理的管理。每项建议的证据质量均通过建议评估、制定和评估分级 (GRADE) 工具进行评估。小组的每个成员单独进行了匿名改进的德尔菲投票程序，以评估对每项声明的同意程度。同意率≥80%的声明被纳入。从最终的报表列表中，选择了较少数量的可审计关键绩效指标 (KPI)，以允许服务对其实践进行基准测试。希望各服务机构能够根据我们的建议和 KPI 审查其实践，并在需要时开展服务开发，以改善 NAFLD 患者的护理。
Non-alcohol-related fatty liver disease (NAFLD) is common, affecting approximately 25% of the general population. The evidence base for the investigation and management of NAFLD is large and growing, but there is currently little practical guidance to support development of services and delivery of care. To address this, we have produced a series of evidence-based quality standard recommendations for the management of NAFLD, with the aim of driving improvement in patient care. A multidisciplinary group of experts from the British Association for the Study of the Liver (BASL) and British Society of Gastroenterology (BSG) NAFLD Special Interest Group (SIG) produced the recommendations covering: 1. Management of people with, or at risk of, NAFLD before the gastroenterology or liver clinic; 2. Assessment and investigations in secondary care, and 3. Management in secondary care. The quality of evidence for each recommendation was evaluated by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) tool. An anonymous modified Delphi voting process was conducted individually by each member of the group to assess the level of agreement with each statement. Statements were included where agreement was ≥80%. From the final list of statements, a smaller number of auditable key performance indicators (KPIs) were selected to allow services to benchmark their practice. It is hoped that services will review their practice against our recommendations and KPIs and institute service development where needed to improve the care of patients with NAFLD.