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Abstract Details
Clinical Care Pathway for the Risk Stratification and Management of Patients With Nonalcoholic Fatty Liver Disease
1Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Veterans Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness, and Safety, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas.
2Touro University California College of Osteopathic Medicine, Vallejo, California.
3University of Western Australia Medical School, Perth, Western Australia, Australia.
4College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan.
5Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China.
6Department of Medicine, Duke University School of Medicine, Durham, North Carolina.
7Radcliffe Department of Medicine, Oxford University, Oxford, UK.
8NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, California.
9Harvard Medical School, Boston, Massachusetts.
10Department of Medical Sciences, University of Torino, Torino, Italy.
11University of Colorado, Anschutz Medical Campus, Aurora, Colorado.
12Harvard Medical School, Boston, Massachusetts; Gastroenterology Division, Massachusetts General Hospital, Boston, Massachusetts.
13University of Florida, Gainesville, Florida; Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida. Electronic address: Kenneth.cusi@medicine.ufl.edu.
Abstract
Find AGA's NASH Clinical Care Pathway App for iOS and Android mobile devices at nash.gastro.org. Scan this QR code to be taken directly to the website.Nonalcoholic fatty liver disease (NAFLD) is becoming increasingly common, currently affecting approximately 37% of US adults. NAFLD is most often managed in primary care or endocrine clinics, where clinicians must determine which patients might benefit from secondary care to address hepatic manifestations, comorbid metabolic traits, and cardiovascular risks of the disease. Because NAFLD is largely asymptomatic, and because optimal timing of treatment depends on accurate staging of fibrosis risk, screening at the primary care level is critical, together with consistent, timely, evidence-based, widely accessible, and testable management processes. To achieve these goals, the American Gastroenterological Association assembled a multidisciplinary panel of experts to develop a Clinical Care Pathway providing explicit guidance on the screening, diagnosis, and treatment of NAFLD. This article describes the NAFLD Clinical Care Pathway they developed and provides a rationale supporting proposed steps to assist clinicians in diagnosing and managing NAFLD with clinically significant fibrosis (stage F2-F4) based on the best available evidence. This Pathway is intended to be applicable in any setting where care for patients with NAFLD is provided, including primary care, endocrine, obesity medicine, and gastroenterology practices.