Evidence map›Paper›PMID 39797660›Full record

Trial reportBMJ open gastroenterology2024

Parallel randomised trial testing community fibrosis assessment for suspected non-alcoholic fatty liver disease: outcomes from LOCATE-NAFLD.

Ruth Tulleners, Adrian Barnett, James O'Beirne, Elizabeth Powell, Ingrid J Hickman, Patricia C Valery, Sanjeewa Kularatna, Katherine Stuart, Carolyn McIvor, Elen Witness and 2 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Trial
  2. Review
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

12 authors.

Ruth TullenersAustralian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.ORCID 0000-0002-9678-6436
Adrian BarnettAustralian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
James O'BeirneUniversity of the Sunshine Coast, Birtinya, Queensland, Australia.ORCID 0000-0003-3400-2816
Elizabeth PowellPrincess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Ingrid J HickmanULTRA Team, The University of Queensland Clinical Trials Capability, Herston, Queensland, Australia.
Patricia C ValeryQIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
Sanjeewa KularatnaAustralian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Katherine StuartPrincess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Carolyn McIvorRamsay Health Care, Brisbane, Queensland, Australia.
Elen WitnessSunshine Coast University Hospital and Health Service, Birtinya, Queensland, Australia.
Melanie AikebusePrincess Alexandra Hospital, Woolloongabba, Queensland, Australia.
David BrainAustralian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia David.Brain@qut.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNon-alcoholic fatty liver disease (NAFLD) is estimated to affect a third of Australian adults, and its prevalence is predicted to rise, increasing the burden on the healthcare system. The LOCal Assessment and Triage Evaluation of Non-Alcoholic Fatty Liver Disease (LOCATE-NAFLD) trialled a community-based fibrosis assessment service using FibroScan to reduce the time to diagnosis of high-risk NAFLD and improve patient outcomes.

methodsWe conducted a 1:1 parallel randomised trial to compare two alternative models of care for NAFLD diagnosis and assessment. Participants had suspected NAFLD and were referred to a hepatology clinic in one of three major hospitals in South-East Queensland. Eligible consenting participants were randomised to receive usual care or the intervention (LOCATE). Participants in the intervention arm received a FibroScan outside of the hospital setting, with results provided to their primary care provider and the referring hepatologist. All participants were followed up 12 months after randomisation to measure their clinical and patient-reported outcomes.

results97 participants were recruited from October 2020 to December 2022. Of the 50 participants randomised to the intervention arm, one failed to attend their appointment, and of the 48 (98%) who had a FibroScan 13 (27%) had a liver stiffness measurement of 8.0 kPa or greater. The HR for the time to diagnosis of high risk was 1.28 (95% CI 0.59 to 2.79), indicating a faster average time to diagnosis with the intervention, but failing to conclusively demonstrate a faster time. The intervention did greatly reduce the time to FibroScan by almost 1 year (median difference 0.92 years, 95% CI 0.56 to 1.45). Other clinical outcomes showed minimal changes.

conclusionThe LOCATE model shows potential for impact, particularly in reducing waiting times for patients at high risk of developing severe liver disease due to NAFLD. A larger sample and longer follow-ups are needed to measure additional clinical outcomes. TRIAL REGISTRATION NUMBER: ACTRN12620000158965.

Indexed as

Elasticity Imaging TechniquesLiver CirrhosisNon-alcoholic Fatty Liver DiseaseTriageAdultAgedFemaleHumansMaleMiddle AgedQueenslandCLINICAL DECISION MAKINGCLINICAL TRIALSFATTY LIVERHEALTH SERVICE RESEARCH

Identifiers

PMID39797660
PMCPMC11664381

What Socratic holds

Textmetadata
LicenceCC BY-NC
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.