A survey of 751 U.S. based gastroenterologists/hepatologists, endocrinologists, and primary care physicians conducted in May 2020, revealed significant disparities between published practice guidance and the clinical realities of diagnosing and managing NAFLD and NASH. These disparities were seen both among specialists with extensive experience in liver disease and among other practitioners likely to see relatively large numbers of NAFLD and NASH patients. The findings suggest a considerable need for broad-based education to increase awareness about guideline-based diagnosis and management of NAFLD and NASH.
Research Purpose: Assess educational needs that will eliminate barriers and gaps experienced by HCPs in the diagnosis and management of NASH, and share the results with the entire medical community in order to enhance future medical education programs.
Study Objectives: Compare current diagnostic and treatment patterns of the management of NASH among gastroenterologists/hepatologists, endocrinologists, and primary care physicians in the US with the most recent practice guidance on NASH*
*“The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases” [Chalasani et al. 2018]
Question: Roughly what proportion of the following patient groups are likely to have NAFLD?
Note: Patients with severe obesity, T2DM, and/or dyslipidemia may not be screened for NAFLD and NASH
Question: Ways to approach non-invasive diagnosis of steatohepatitis and advanced fibrosis in NAFLD.
Note: Many respondents incorrectly consider abdominal ultrasound to be a clinically useful tool for diagnosing NASH and advanced fibrosis.
Question: Ways to approach non-invasive diagnosis of steatohepatitis and advanced fibrosis in NAFLD
*P value of <.05 indicate relationship between knowledge of the guidelines and specialty sub-group
Note: Clinicians may be overlooking low-cost treatments for NASH, most notably vitamin E and pioglitazone.
Note: Most respondents would like more education on screening, diagnosing and treating NASH.