A global action agenda for turning the tide on fatty liver disease.
A global action agenda for turning the tide on fatty liver disease.
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DOI：
10.1097/hep.0000000000000545
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发表时间：
2024-02-01
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脂肪肝是一种主要的公共卫生威胁，由于其非常高的患病率和相关的发病率和死亡率。迫切需要有针对性的专门干预措施，以针对疾病预防、治疗和护理。我们为全球脂肪肝疾病实践社区制定了一个统一的优先行动议程。在2轮德尔菲方法之后，一个大型小组（R1 n = 344，R2 n = 288）使用Qualtrics XM审查了行动优先级，使用4分Likert量表表示同意并提供书面反馈。在R2中，小组成员还在6个领域内对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，以及领导和公共卫生政策。共识脂肪肝行动议程包括29个优先事项。在R2中，“同意”的平均百分比为82.4%，所有个人优先级都至少有超多数同意（> 66.7%“同意”）。排名最高的行动优先事项包括肝脏专家和初级保健医生在早期诊断方面的合作，采取行动解决患有多种疾病的人的需求，以及将脂肪肝疾病纳入相关的非传染性疾病战略和指导。这项由医疗服务提供者、临床研究人员以及公共卫生和政策专家制定的共识驱动的多学科脂肪肝行动议程为降低脂肪肝的患病率和改善健康结果提供了一条途径。为了执行这一议程，需要在全球、区域和国家各级作出协调一致的努力。
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.