目标:全球估计有38%的成年人患有非酒精性脂肪性肝病(NAFLD)。从个人影响到广泛的公共卫生和经济后果,这种疾病的影响是深远的。这项研究的目的是发展一个一致的,全球卫生界优先考虑的脂肪肝疾病研究议程。
方法:九位共同主席起草了初步研究重点,随后由40位核心作者进行了审查,并在为期三天的面对面会议上进行了辩论。遵循Delphi方法,经过两轮,一个大小组(R1n=344,R2n=288)审查了优先事项,通过QualtricsXM,使用四点李克特量表表示同意,并提供书面反馈。核心小组修订了各轮之间的优先事项草案。在R2中,小组成员还对六个领域的优先事项进行了排名:流行病学,护理模式,治疗和护理,教育和意识,病人和社区的观点,领导和公共卫生政策。
结果:达成共识的脂肪肝疾病研究议程包括28个优先事项。“同意”响应的平均百分比从R1的78.3增加到R2的81.1。五个优先级获得了一致的合并协议(\'同意\'\'有点同意\');其余23个优先级的合并协议>90%。虽然除一项优先事项外,所有优先事项至少都表现出了超多数同意(>66.7%的“同意”),13个优先级<80%\'同意\',在更大程度上依赖“有点同意”的情况下,实现>90%的合并协议。
结论:采用这种多学科共识建立的研究重点议程可以在解决脂肪肝疾病方面实现阶段性转变,减轻其个人和社会危害,并通过预防积极改变其自然历史,identification,治疗,和关心。该议程应促进全球卫生界努力推进和加快应对这一广泛和快速增长的公共卫生威胁。
■全世界估计有38%的成年人和13%的儿童和青少年患有脂肪肝,使其成为历史上最常见的肝病.尽管在过去的三十年里取得了巨大的科学进步,负担继续增加,迫切需要进一步了解如何预防,管理,并治疗疾病。通过全球共识进程,一个多学科小组商定了28项研究重点,涵盖广泛的主题,从疾病负担,治疗,以及卫生系统对意识和政策的反应。这些发现对于临床和非临床研究人员以及更广泛地研究脂肪肝和非传染性疾病的资助者具有相关性,列出优先顺序,排名研究议程,以扭转这一快速增长的公共卫生威胁的潮流。
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.
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.
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.
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.
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.