Tsochatzis, Emmanuel A;
Valenti, Luca;
Thiele, Maja;
Péloquin, Sophie;
Lazure, Patrice;
Masson, Mounia Heddad;
Allen, Alina M;
... Murray, Suzanne; + view all
(2024)
Use of non‐invasive diagnostic tools for metabolic dysfunction‐associated steatohepatitis: A qualitative exploration of challenges and barriers.
Liver International
, 44
(8)
pp. 1990-2001.
10.1111/liv.15941.
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Tsochatzis_Tsochatzis et al (2024) Manuscript Liver Intl - AXDEV REV 1.0. 20240227.pdf Access restricted to UCL open access staff until 19 April 2025. Download (428kB) |
Abstract
BACKGROUND AND AIMS: Non‐invasive tests (NITs) are underutilized for diagnosis and risk stratification in metabolic dysfunction‐associated steatotic liver disease (MASLD), despite good accuracy. This study aimed to identify challenges and barriers to the use of NITs in clinical practice. METHODS: We conducted a qualitative exploratory study in Germany, Italy, United Kingdom and United States. Phase 1 participants (primary care physicians, hepatologists, diabetologists, researchers, healthcare administrators, payers and patient advocates; n = 29) were interviewed. Phase 2 participants (experts in MASLD; n = 8) took part in a group discussion to validate and expand on Phase 1 findings. Finally, we triangulated perspectives in a hybrid deductive/inductive thematic analysis. RESULTS: Four themes hindering the use of NITs emerged: (1) limited knowledge and awareness; (2) unclear referral pathways for patients affected by liver conditions; (3) uncertainty over the value of NITs in monitoring and managing liver diseases; and (4) challenges justifying system‐level reimbursement. Through these themes, participants perceived a stigma associated with liver diseases, and primary care physicians generally lacked awareness, adequate knowledge and skills to use recommended NITs. We identified uncertainties over the results of NITs, specifically to guide lifestyle intervention or to identify patients that should be referred to a specialist. Participants indicated an ongoing need for research and development to improve the prognostic value of NITs and communicating their cost‐effectiveness to payers. CONCLUSIONS: This qualitative study suggests that use of NITs for MASLD is limited due to several individual and system‐level barriers. Multi‐level interventions are likely required to address these barriers.
| Type: | Article |
|---|---|
| Title: | Use of non‐invasive diagnostic tools for metabolic dysfunction‐associated steatohepatitis: A qualitative exploration of challenges and barriers |
| Location: | United States |
| DOI: | 10.1111/liv.15941 |
| Publisher version: | https://doi.org/10.1111/liv.15941 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Elastography, steatotic liver disease, Fibrosis-4 (FIB4) score, cirrhosis, Enhanced Liver Fibrosis (ELF) score, magnetic resonance imaging (MRI) |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10196317 |
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