New dimensions for hospital services and early detection of disease: a Review from the Lancet Commission into liver disease in the UK

Alessi, Charles; Alexander, Graeme; Allison, Michael; Aspinall, Richard J; Batterham, Rachel L.; Bhala, Neeraj; Day, Natalie; Dhawan, Anil; Drummond, Colin; Ferguson, James; Foster, Graham; Gilmore, Ian; Goldacre, Raphael; Gordon, Harriet; Henn, Clive; Kelly, Déirdre; MacGilchrist, Alastair; McCorry, Roger; McDougall, Neil; Mirza, Zul; Moriarty, Kieran; Newsome, Philip N.; Pinder, Richard; Roberts, Stephen E.; Rutter, Harry; Ryder, Stephen; Samyn, Marianne; Severi, Katherine; Sheron, Nick; Thorburn, Douglas; Verne, Julia; Williams, John; Yeoman, Andrew D.

doi:10.1016/s0140-6736(20)32396-5

Cited by 20 publications

(22 citation statements)

References 41 publications

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“…The importance of improving early diagnosis of BA is well recognized [97] , as the negative impact of late surgery has been demonstrated in previous studies [98] , and novel biomarkers that can stratify patients with regard to the need for liver transplants are warranted. In an ideal world, the investigation for BA should be non-invasive and able to provide accurate and sensitive diagnosis during the early phase of the disease, and although not yet a reality, it is an important aim to work towards this goal.…”

Section: Emerging Diagnostic Opportunities For Biliary Atresiamentioning

confidence: 99%

“…The examination of bile-stained stool in infants with suspected BA is completely non-invasive. Some countries adopted the policy of universal screening of infant stool colour and reported promising results [97] , but the cost-effectiveness remains controversial due to its low specificity. Except the minor discomfort associated with venipuncture, blood tests are nearly non-invasive.…”

Section: Emerging Diagnostic Opportunities For Biliary Atresiamentioning

confidence: 99%

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Biliary Atresia – emerging diagnostic and therapy opportunities

et al. 2021

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Section: Emerging Diagnostic Opportunities For Biliary Atresiamentioning

confidence: 99%

Section: Emerging Diagnostic Opportunities For Biliary Atresiamentioning

confidence: 99%

Biliary Atresia – emerging diagnostic and therapy opportunities

et al. 2021

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“…94 In the setting of the pandemic, the lack of physical activity, mental health issues, and increased alcohol consumption can contribute to the increase of ALD and MAFLD burdens. 95…”

Section: Chronic Liver Diseasementioning

confidence: 99%

COVID‐19 in gastroenterology: Where are we now? Current evidence on the impact of COVID‐19 in gastroenterology

et al. 2021

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Background The COVID‐19 pandemic has created unprecedented challenges in all fields of society with social, economic, and health‐related consequences worldwide. In this context, gastroenterology patients and healthcare systems and professionals have seen their routines changed and were forced to adapt, adopting measures to minimize the risk of infection while guaranteeing continuous medical care to chronic patients. Objective At this point, it is important to evaluate the impact of the pandemic on this field to further improve the quality of the services provided in this context. Methods/Results/Conclusion We performed a literature review that summarizes the main aspects to consider in gastroenterology, during the pandemic crisis, and includes a deep discussion on the main changes affecting gastroenterology patients and healthcare systems, anticipating the pandemic recovery scenario with future practices and policies.

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“…Key to reducing the burden of poor liver health is early diagnosis. Widespread implementation of early diagnosis will be necessary to aid prevention of advanced and disabling forms of liver conditions, and to minimize individual and societal costs [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Patient understanding and experience of non-invasive imaging diagnostic techniques and the liver patient pathway

McKay¹,

Pantoja²,

Hall³

et al. 2021

J Patient Rep Outcomes

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Background Clinical and patient-reported outcomes are positively affected when efforts to increase patient understanding of underlying diseases and foster patient participation are part of care pathways. The prevalence of liver diseases is increasing globally, and successful communication of results from liver diagnostic tests will be important for physicians to ensure patient engagement and encourage adherence to lifestyle changes and therapy. Here, we aimed to explore the impact of non-invasive liver tests on patient experience and patient comprehension of liver disease in chronic liver disease diagnostic pathways typically managed with liver biopsies. Results 101 participants diagnosed with a range of liver disease aetiologies (90 patients, 11 caregivers) underwent a multiparametric magnetic resonance imaging (MRI) test. A subset of 33 participants was subjected to transient elastography (TE) with FibroScan® in addition to multiparametric MRI. MRI results were analysed using LiverMultiScan™. Participants received results on their liver-health status followed by a semi-structured interview to assess the scan procedure experience, comprehension of the results, and experiences of liver disease. A subset of participants (N = 5) was also engaged in the design, execution, and thematic analysis of the interview transcripts of the study. Analysis of semi-structured interviews revealed: (1) Presentation and discussion of the LiverMultiScan visual report by a physician was an effective contributor to better patient experience and increased comprehension of liver disease. (2) Patients demonstrated preference for non-invasive tests over biopsy for management of liver disease. (3) Patients reported positive experiences with the MRI test during the path for liver disease management. Conclusions Patients presented with visual reports of liver test results developed increased understanding of liver disease care which may have contributed to an overall more positive experience. Patients reported that clinical information obtained through non-invasive methods and transmitted through visual reports contributed to clarity, understanding and overall increased satisfaction. We conclude that a shift toward non-invasive testing and visual reporting of clinical information (e.g. picture of liver with visual scale) when possible are likely to contribute to improved physician engagement with patients and lead to better outcomes in the management of chronic liver diseases. Plain English summary Evidence suggests that patient experience and understanding can affect several aspects of clinical care and patient well-being. In this study, 101 patients and patient caregivers affected by liver diseases were recruited to determine how patient experiences of liver disease were affected with the introduction of non-invasive evaluation of the liver with an MRI or ultrasound-based elastography. All 101 participants received an MRI followed by a LiverMultiScan report. 33 participants received an additional FibroScan and report. Following the reports, participants were interviewed and asked to reflect on factors which affected their experience of the procedure and the understanding of their results. We focused on factors related to the layout of the standardised report and the delivery of its results. The interviews were transcribed and analysed for common themes and patterns. Patients and patient advocacy groups were involved in the design and conduct of the study, and analysis of the interview transcripts. Here, we report the perception of patients and patient caregivers on the quality of care and diagnostic experience. Trial registration ClinicalTrials.gov identifier—NCT02877602.

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New dimensions for hospital services and early detection of disease: a Review from the Lancet Commission into liver disease in the UK

Cited by 20 publications

References 41 publications

Biliary Atresia – emerging diagnostic and therapy opportunities

Biliary Atresia – emerging diagnostic and therapy opportunities

COVID‐19 in gastroenterology: Where are we now? Current evidence on the impact of COVID‐19 in gastroenterology

Patient understanding and experience of non-invasive imaging diagnostic techniques and the liver patient pathway

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