A global research priority agenda to advance public health responses to fatty liver disease

Healthy Livers, Healthy Lives Collaborators; Jeffrey V Lazarus; Henry E Mark; Alina M Allen; Juan Pablo Arab; Patrizia Carrieri; Mazen Noureddin; William Alazawi; Naim Alkhouri; Saleh A. Alqahtani; Marco Arrese; Ramon Bataller; Thomas Berg; Paul N Brennan; Patrizia Burra; Graciela E. Castro Narro; Helena Cortez-Pinto; Kenneth Cusi; Nikos Dedes; Ajay Duseja; Sven M Francque; Hannes Hagström; Terry T-K Huang; Dana Ivancovsky Wajcman; Achim Kautz; Christopher J. Kopka; Aleksander Krag; Veronica Miller; Philip N Newsome; Mary E Rinella; Diana Romero; Shiv Kumar Sarin; Marcelo Silva; C. Wendy Spearman; Emmanuel A Tsochatzis; Luca Valenti; Marcela Villota-Rivas; Shira Zelber-Sagi; Jörn M Schattenberg; Vincent Wai-Sun Wong; Zobair M Younossi

doi:10.1016/j.jhep.2023.04.035

A global research priority agenda to advance public health responses to fatty liver disease

Healthy Livers, Healthy Lives Collaborators, Jeffrey V Lazarus^*, Henry E Mark, Alina M Allen, Juan Pablo Arab, Patrizia Carrieri, Mazen Noureddin, William Alazawi, Naim Alkhouri, Saleh A. Alqahtani, Marco Arrese, Ramon Bataller, Thomas Berg, Paul N Brennan, Patrizia Burra, Graciela E. Castro Narro, Helena Cortez-Pinto, Kenneth Cusi, Nikos Dedes, Ajay DusejaSven M Francque, Hannes Hagström, Terry T-K Huang, Dana Ivancovsky Wajcman, Achim Kautz, Christopher J. Kopka, Aleksander Krag, Veronica Miller, Philip N Newsome, Mary E Rinella, Diana Romero, Shiv Kumar Sarin, Marcelo Silva, C. Wendy Spearman, Emmanuel A Tsochatzis, Luca Valenti, Marcela Villota-Rivas, Shira Zelber-Sagi, Jörn M Schattenberg, Vincent Wai-Sun Wong, Zobair M Younossi

^*Corresponding author for this work

Medicine and Health

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Abstract

BACKGROUND & AIMS: An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community.

METHODS: Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy.

RESULTS: The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of 'agree' responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement ('agree' + 'somewhat agree'); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% 'agree'), 13 priorities had <80% 'agree', with greater reliance on 'somewhat agree' to achieve >90% combined agreement.

CONCLUSIONS: Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community's efforts to advance and accelerate responses to this widespread and fast-growing public health threat.

IMPACT AND IMPLICATIONS: An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat.

Original language	English
Pages (from-to)	618-634
Number of pages	17
Journal	Journal of Hepatology
Volume	79
Issue number	3
Early online date	20 Jun 2023
DOIs	https://doi.org/10.1016/j.jhep.2023.04.035
Publication status	Published - Sept 2023

Bibliographical note

Financial support:
The data collection and analysis were funded by the European Association for the Study of the Liver (EASL), with support from Takeda, MSD, Bristol-Myers-Squibb Company, and Apollo Endo.

Copyright:
© 2023 The Author(s). Published by Elsevier B.V.

Keywords

Child
Humans
Adolescent
Non-alcoholic Fatty Liver Disease/epidemiology
Public Health
Research
Global Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Healthy Livers, Healthy Lives Collaborators, Lazarus, J. V., Mark, H. E., Allen, A. M., Arab, J. P., Carrieri, P., Noureddin, M., Alazawi, W., Alkhouri, N., Alqahtani, S. A., Arrese, M., Bataller, R., Berg, T., Brennan, P. N., Burra, P., Castro Narro, G. E., Cortez-Pinto, H., Cusi, K., Dedes, N., ... Younossi, Z. M. (2023). A global research priority agenda to advance public health responses to fatty liver disease. Journal of Hepatology, 79(3), 618-634. https://doi.org/10.1016/j.jhep.2023.04.035

@article{f90f3c61c8f642ffa82014ba7dffcf18,

title = "A global research priority agenda to advance public health responses to fatty liver disease",

abstract = "BACKGROUND & AIMS: An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community.METHODS: Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy.RESULTS: The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of 'agree' responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement ('agree' + 'somewhat agree'); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% 'agree'), 13 priorities had <80% 'agree', with greater reliance on 'somewhat agree' to achieve >90% combined agreement.CONCLUSIONS: Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community's efforts to advance and accelerate responses to this widespread and fast-growing public health threat.IMPACT AND IMPLICATIONS: An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat.",

keywords = "Child, Humans, Adolescent, Non-alcoholic Fatty Liver Disease/epidemiology, Public Health, Research, Global Health",

author = "{Healthy Livers, Healthy Lives Collaborators} and Lazarus, {Jeffrey V} and Mark, {Henry E} and Allen, {Alina M} and Arab, {Juan Pablo} and Patrizia Carrieri and Mazen Noureddin and William Alazawi and Naim Alkhouri and Alqahtani, {Saleh A.} and Marco Arrese and Ramon Bataller and Thomas Berg and Brennan, {Paul N} and Patrizia Burra and {Castro Narro}, {Graciela E.} and Helena Cortez-Pinto and Kenneth Cusi and Nikos Dedes and Ajay Duseja and Francque, {Sven M} and Hannes Hagstr{\"o}m and Huang, {Terry T-K} and Wajcman, {Dana Ivancovsky} and Achim Kautz and Kopka, {Christopher J.} and Aleksander Krag and Veronica Miller and Newsome, {Philip N} and Rinella, {Mary E} and Diana Romero and Sarin, {Shiv Kumar} and Marcelo Silva and Spearman, {C. Wendy} and Tsochatzis, {Emmanuel A} and Luca Valenti and Marcela Villota-Rivas and Shira Zelber-Sagi and Schattenberg, {J{\"o}rn M} and Wong, {Vincent Wai-Sun} and Younossi, {Zobair M}",

note = "Financial support: The data collection and analysis were funded by the European Association for the Study of the Liver (EASL), with support from Takeda, MSD, Bristol-Myers-Squibb Company, and Apollo Endo. Copyright: {\textcopyright} 2023 The Author(s). Published by Elsevier B.V.",

year = "2023",

month = sep,

doi = "10.1016/j.jhep.2023.04.035",

language = "English",

volume = "79",

pages = "618--634",

journal = "Journal of Hepatology",

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publisher = "Elsevier",

number = "3",

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Healthy Livers, Healthy Lives Collaborators, Lazarus, JV, Mark, HE, Allen, AM, Arab, JP, Carrieri, P, Noureddin, M, Alazawi, W, Alkhouri, N, Alqahtani, SA, Arrese, M, Bataller, R, Berg, T, Brennan, PN, Burra, P, Castro Narro, GE, Cortez-Pinto, H, Cusi, K, Dedes, N, Duseja, A, Francque, SM, Hagström, H, Huang, TT-K, Wajcman, DI, Kautz, A, Kopka, CJ, Krag, A, Miller, V, Newsome, PN, Rinella, ME, Romero, D, Sarin, SK, Silva, M, Spearman, CW, Tsochatzis, EA, Valenti, L, Villota-Rivas, M, Zelber-Sagi, S, Schattenberg, JM, Wong, VW-S & Younossi, ZM 2023, 'A global research priority agenda to advance public health responses to fatty liver disease', Journal of Hepatology, vol. 79, no. 3, pp. 618-634. https://doi.org/10.1016/j.jhep.2023.04.035

TY - JOUR

T1 - A global research priority agenda to advance public health responses to fatty liver disease

AU - Healthy Livers, Healthy Lives Collaborators

AU - Lazarus, Jeffrey V

AU - Mark, Henry E

AU - Allen, Alina M

AU - Arab, Juan Pablo

AU - Carrieri, Patrizia

AU - Noureddin, Mazen

AU - Alazawi, William

AU - Alkhouri, Naim

AU - Alqahtani, Saleh A.

AU - Arrese, Marco

AU - Bataller, Ramon

AU - Berg, Thomas

AU - Brennan, Paul N

AU - Burra, Patrizia

AU - Castro Narro, Graciela E.

AU - Cortez-Pinto, Helena

AU - Cusi, Kenneth

AU - Dedes, Nikos

AU - Duseja, Ajay

AU - Francque, Sven M

AU - Hagström, Hannes

AU - Huang, Terry T-K

AU - Wajcman, Dana Ivancovsky

AU - Kautz, Achim

AU - Kopka, Christopher J.

AU - Krag, Aleksander

AU - Miller, Veronica

AU - Newsome, Philip N

AU - Rinella, Mary E

AU - Romero, Diana

AU - Sarin, Shiv Kumar

AU - Silva, Marcelo

AU - Spearman, C. Wendy

AU - Tsochatzis, Emmanuel A

AU - Valenti, Luca

AU - Villota-Rivas, Marcela

AU - Zelber-Sagi, Shira

AU - Schattenberg, Jörn M

AU - Wong, Vincent Wai-Sun

AU - Younossi, Zobair M

N1 - Financial support: The data collection and analysis were funded by the European Association for the Study of the Liver (EASL), with support from Takeda, MSD, Bristol-Myers-Squibb Company, and Apollo Endo. Copyright: © 2023 The Author(s). Published by Elsevier B.V.

PY - 2023/9

Y1 - 2023/9

N2 - BACKGROUND & AIMS: An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community.METHODS: Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy.RESULTS: The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of 'agree' responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement ('agree' + 'somewhat agree'); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% 'agree'), 13 priorities had <80% 'agree', with greater reliance on 'somewhat agree' to achieve >90% combined agreement.CONCLUSIONS: Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community's efforts to advance and accelerate responses to this widespread and fast-growing public health threat.IMPACT AND IMPLICATIONS: An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat.

AB - BACKGROUND & AIMS: An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community.METHODS: Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy.RESULTS: The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of 'agree' responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement ('agree' + 'somewhat agree'); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% 'agree'), 13 priorities had <80% 'agree', with greater reliance on 'somewhat agree' to achieve >90% combined agreement.CONCLUSIONS: Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community's efforts to advance and accelerate responses to this widespread and fast-growing public health threat.IMPACT AND IMPLICATIONS: An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat.

KW - Child

KW - Humans

KW - Adolescent

KW - Non-alcoholic Fatty Liver Disease/epidemiology

KW - Public Health

KW - Research

KW - Global Health

U2 - 10.1016/j.jhep.2023.04.035

DO - 10.1016/j.jhep.2023.04.035

M3 - Article

C2 - 37353401

SN - 0168-8278

VL - 79

SP - 618

EP - 634

JO - Journal of Hepatology

JF - Journal of Hepatology

IS - 3

ER -

A global research priority agenda to advance public health responses to fatty liver disease

Abstract

Bibliographical note

Keywords

UN SDGs

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