Evidence mapPaperPMID 39640981Full record

ArticleFrontiers in medicine2024

Development and pilot evaluation of an evidence-based algorithm for MASLD (formerly NAFLD) management in primary care in Europe.

Marilena Anastasaki, Sophia Papadakis, Irini N Gergianaki, Loucas Papastamatiou, Eftychios Aligizakis, Nikoleta Grillaki, Eleni Boutzoukaki, Nektarios Sivaropoulos, Foteini Anastasiou, Juan Mendive and 8 more

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Article in Frontiers in medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

18 authors.

Marilena AnastasakiClinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
Sophia PapadakisClinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
Irini N GergianakiClinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
Loucas PapastamatiouKandanos Healthcare Center, Chania, Greece.
Eftychios AligizakisKandanos Healthcare Center, Chania, Greece.
Nikoleta GrillakiSecond Healthcare Center of Chania, Chania, Greece.
Eleni BoutzoukakiAlikianos Rural Practice, Chania, Greece.
Nektarios SivaropoulosSpili Healthcare Center, Rethymno, Greece.
Foteini AnastasiouClinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
Juan MendiveEuropean Society for Primary Care Gastroenterology, Stockholm, Sweden.
Carlos de Juan-AsenjoLa Mina Primary Health Care Centre-IDIAP Jordi Gol, Barcelona, Spain.
Rosario Hernández-IbáñezLa Marina Health Centre, Barcelona, Spain.
Alba Martínez-EscudéMASLD Working Group, Catalan Society of Family Medicine (CAMFiC), Barcelona, Spain.
Montserrat Garcia-RetortilloHepatology Unit, Hospital del Mar, Barcelona, Spain.
Ger KoekDepartment of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, Netherlands.
Leen HeyensFaculty of Health and Life Sciences, Hasselt University, Diepenbeek, Belgium.
Jean MurisEuropean Society for Primary Care Gastroenterology, Stockholm, Sweden.
Christos D LionisClinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD), emerges as major cause of morbidity and mortality globally, with chronic patients facing increased risk. Guidelines on MASLD management in primary care (PC) are limited. This study aimed to develop and evaluate a clinical care pathway for use in PC to improve MASLD screening and management, including early detection, communication and treatment, in three European countries (Greece, Spain, the Netherlands). Methods: An international multidisciplinary panel of experts oversaw pathway development, which was designed as a two-step algorithm with defined and sequenced tasks. To evaluate algorithm implementation, a controlled pilot study was conducted. Patients at risk of MASLD were assigned to general practitioners (GPs) trained in algorithm implementation (active group) or usual care (control group) and followed for 4-8 weeks. Primary outcomes were the number of patients screened for MASLD, managed in PC and referred to specialists. Results: In this algorithm, patients with metabolic or liver dysfunction, confirmed MASLD or cardiovascular disease are screened with FIB-4 and classified as having risk of low-level (FIB-4 < 1.3), intermediate-level (1.3 ≤ FIB-4 < 2.67) or high-level MASLD (FIB-4 ≥ 2.67). The algorithm provides evidence-based tools to support GPs manage patients with risk of low-level MASLD in PC, coordinate linkage of patients with risk of high-level MASLD to specialists and refer patients with risk of intermediate-level MASLD for elastography (low-risk if <7.9 kPa or intermediate/high-risk if ≥7.9 kPa). During pilot evaluation, Conclusion: This study provides evidence on the development and implementation of a new PC algorithm for MASLD screening and management. Variations among participating settings in algorithm implementation are indicative of context-specific particularities. Further research is necessary for integrating such pathways in tailored interventions to tackle this emerging public health issue.

Indexed as

clinical care pathwaysmanagementmetabolic dysfunction-associated steatotic liver disease (MASLD)non-alcoholic fatty liver disease (NAFLD)primary carerisk classificationscreening

Identifiers

PMID39640981
PMCPMC11617198

What Socratic holds

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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.