Evidence map›Paper›PMID 35413987›Full record

ArticleBMC health services research2022

Implementing the right care in the right place at the right time for non-alcoholic fatty liver disease (NAFLD-RRR study): a study protocol for a community care pathway for people with type 2 diabetes.

Lucy Gracen, Kelly L Hayward, Melanie Aikebuse, Anthony Russell, James O'Beirne, Steven McPhail, Katharine M Irvine, Suzanne Williams, Patricia C Valery, Elizabeth E Powell

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

Lucy GracenCentre for Liver Disease Research, Faculty of Medicine, Translational Research Institute, The University of Queensland, Level 5, West Wing, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia.
Kelly L HaywardCentre for Liver Disease Research, Faculty of Medicine, Translational Research Institute, The University of Queensland, Level 5, West Wing, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia.
Melanie AikebuseCentre for Liver Disease Research, Faculty of Medicine, Translational Research Institute, The University of Queensland, Level 5, West Wing, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia.
Anthony RussellCentre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.
James O'BeirneDepartment of Gastroenterology and Hepatology, Sunshine Coast University Hospital, Birtinya, QLD, Australia.
Steven McPhailAustralian Centre for Health Services Innovation School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
Katharine M IrvineMater Research, Translational Research Institute, Brisbane, QLD, Australia.
Suzanne WilliamsInala Primary Care General Practice, Inala, QLD, Australia.
Patricia C ValeryCentre for Liver Disease Research, Faculty of Medicine, Translational Research Institute, The University of Queensland, Level 5, West Wing, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia.
Elizabeth E PowellCentre for Liver Disease Research, Faculty of Medicine, Translational Research Institute, The University of Queensland, Level 5, West Wing, 37 Kent Street, Woolloongabba, Brisbane, QLD, 4102, Australia. e.powell@uq.edu.au.
The University of Queensland · AUPrincess Alexandra Hospital · AUInala Community Health Centre · AUMetro South Health · AUQIMR Berghofer Medical Research Institute · AUSunshine Coast University Hospital · AUTranslational Research Institute · AU

Funding

Health Innovation, Investment and Research Office Clinical Research FellowshipMetro South Health Research Support Scheme GrantNational Health and Medical Research Council 1161138
6 · The paper itself

Abstract

backgroundNon-alcoholic fatty liver disease (NAFLD) is an emerging epidemic that affects approximately half of all people with type 2 diabetes. Those with type 2 diabetes are a high-risk NAFLD subgroup because of their increased risk of clinically significant liver-related outcomes from NAFLD which include hepatocellular carcinoma, cirrhosis-related complications and liver disease mortality. They may benefit from early detection of disease as this would allow at risk patients to access hepatocellular carcinoma surveillance, emerging drug trials for NAFLD and specialist hepatology care prior to emergence of liver-related complications.

methodsThis is a prospective cohort study aimed at incorporating and assessing a community care pathway for liver fibrosis screening into routine care for type 2 diabetes. Patients undergo a point of care assessment of hepatic steatosis and stiffness using FibroScan at the time of the routine diabetes appointment or when attending the clinic for blood tests in preparation for this appointment. DISCUSSION: We propose that implementation of a community-based NAFLD diagnosis, risk-stratification, and referral pathway for people with type 2 diabetes is feasible, will provide earlier, targeted detection of advanced fibrosis, and reduce unnecessary referrals to hepatology outpatients for fibrosis risk assessment. Our study will provide important information about the feasibility of establishing a NAFLD pathway for people with type 2 diabetes in primary care. Ultimately, our findings will help direct spending and resource allocation for NAFLD in a high-risk population. Regular evaluation by stakeholders during implementation will help to create a reliable and sustainable community care pathway and establish a perpetual cycle of learning in primary care.

trial registrationANZCTR, ACTRN12621000330842 . Registered 23 March 2021.

Indexed as

Carcinoma, HepatocellularDiabetes Mellitus, Type 2Liver NeoplasmsNon-alcoholic Fatty Liver DiseaseCritical PathwaysFibrosisHumansLiver CirrhosisProspective StudiesCirrhosisDelivery of health careDiabetes complicationsIntegratedPatient careRisk assessment

Identifiers

PMID35413987
PMCPMC9004198
OpenAlexW4223459476

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.