Expert Review of Gastroenterology & Hepatology最新文献

Specialized and standard nutritional formulas for the dietary management of pediatric patients with Crohn's disease: a systematic literature review.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-08 DOI: 10.1080/17474124.2025.2488887

Richard K Russell, Andrew Fagbemi, Jalil Benyacoub, Maria E Capobianco, Laura E Wells, Rita Shergill-Bonner, Preeti Sharma, Minal Patel

{"title":"Specialized and standard nutritional formulas for the dietary management of pediatric patients with Crohn's disease: a systematic literature review.","authors":"Richard K Russell, Andrew Fagbemi, Jalil Benyacoub, Maria E Capobianco, Laura E Wells, Rita Shergill-Bonner, Preeti Sharma, Minal Patel","doi":"10.1080/17474124.2025.2488887","DOIUrl":"https://doi.org/10.1080/17474124.2025.2488887","url":null,"abstract":"Introduction: This systematic literature review (SLR) aimed to compare the clinical, humanistic, and economic outcomes associated with specialized and standard nutritional formulas for the treatment of mild-to-moderate pediatric Crohn's disease.Methods: Search strategies were applied across MEDLINE, Cochrane and Web of Science (January 2000-October 2023) and recent congress proceedings (January 2021-October 2023). PRISMA-P guidelines were followed. Quality assessment evaluated risk of bias.Results: Twenty-three unique studies met the inclusion criteria. Nineteen studies (754 patients) evaluated specialized formula, 10 assessed standard formula (246 patients). Mucosal healing (7 studies), induction (20 studies) and maintenance of remission (9 studies) were reported over various timeframes. High proportions of patients who received specialized formula achieved mucosal healing (63-89% 8 weeks; 25-74% 10 weeks), and remission (50-100% 8 weeks). Specialized formula sustained remission (34-62.5% 6 months and 24-87.5% 1 year). Results were not directly comparable with standard formula due to significant heterogeneity in study methodology, patient population, and remission definition.Conclusions: The evidence predominantly supports the benefits of specialized formula in inducing mucosal healing, remission, and sustaining positive outcomes across multiple timepoints. Direct comparison of nutritional interventions is required to further support the findings of this SLR. Protocol registration: PROSPERO CRD42023472370.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

PALLIATIVE CARE & MANAGEMENT of SYMPTOMS in ADVANCED LIVER DISEASE: AN EXPERT REVIEW.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-08 DOI: 10.1080/17474124.2025.2491529

Jessica L Allen, Richard K Sterling

{"title":"PALLIATIVE CARE & MANAGEMENT of SYMPTOMS in ADVANCED LIVER DISEASE: AN EXPERT REVIEW.","authors":"Jessica L Allen, Richard K Sterling","doi":"10.1080/17474124.2025.2491529","DOIUrl":"https://doi.org/10.1080/17474124.2025.2491529","url":null,"abstract":"Introduction: Chronic liver disease (CLD) is a leading cause of death worldwide. End stage liver disease (ESLD) causes a rapid and progressive decline in health and quality of life (QOL) and creates significant suffering and burdens for patients, families and health systems alike. These patients have significant physical, psychological and complex social needs that benefit from the support of an interdisciplinary palliative care (PC) team.Areas covered: This review of the English literature analyzes general palliative care principles for the CLD and ESLD populations including factors affecting QOL and review of symptom management per AASLD and AGA Guidelines. We have also reviewed the impacts of palliative support on QOL, caregiver burden, and healthcare related outcomes.Expert opinion: ESLD causes significant suffering and burdens for patients, families and healthcare systems. PC is an essential component of ESLD care and improves QOL, caregiver burdens and shows benefits of reduced health care costs and aggressive care at end of life. Provider and community misunderstanding or inexperience of PC is often a barrier to PC involvement. There is a clear lack of standardization in medical training and lack of clear guidelines on when to involve PC in the ESLD population that must be addressed.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical management of acute severe ulcerative colitis in the hospitalized patient.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-06 DOI: 10.1080/17474124.2025.2488884

Loren G Rabinowitz, Ajay Gade, Joseph D Feuerstein

{"title":"Medical management of acute severe ulcerative colitis in the hospitalized patient.","authors":"Loren G Rabinowitz, Ajay Gade, Joseph D Feuerstein","doi":"10.1080/17474124.2025.2488884","DOIUrl":"10.1080/17474124.2025.2488884","url":null,"abstract":"Introduction: Approximately one in every four patients with ulcerative colitis will develop acute severe ulcerative colitis (ASUC). Historically, this was managed with intravenous steroids and surgery when steroids failed. The use of rescue therapy.Areas covered: This review summarizes the latest research in the management of hospitalized patients with ASUC. Covering the historical data and success of rescue therapy with cyclosporine and then with infliximab changed outcomes and reduced the risk of colectomy during the hospitalization and at 1 year. More recently, more biologics and small molecules have been approved and more patients present to the hospital with ASUC already failing anti-tumor necrosis factor antagonists. More recent studies have shown some efficacy of rescue therapy with other classes of biologics (e.g. interleukins and anti-integrins). The more recently approved small molecules (i.e. tofacitinib and Upadacitinib) have shown a rapid onset in therapeutic efficacy in as little as 1 day with sustained response at 1 year in reducing the risk of colectomy following ASUC.Expert opinion: In the expert opinion, we discuss the challenges in the treatment of patients with ASUC. We summarize the data of current biologics and new small molecules and their emerging roles in the management of ASUC.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-14"},"PeriodicalIF":3.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Identifying and managing rare subtypes of gastrointestinal stromal tumors. 识别和管理罕见的胃肠道间质瘤亚型。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 DOI: 10.1080/17474124.2025.2486304

Leonidas Mavroeidis, Foteini Kalofonou, Ruth Casey, Andrea Napolitano, Ramesh Bulusu, Robin L Jones

{"title":"Identifying and managing rare subtypes of gastrointestinal stromal tumors.","authors":"Leonidas Mavroeidis, Foteini Kalofonou, Ruth Casey, Andrea Napolitano, Ramesh Bulusu, Robin L Jones","doi":"10.1080/17474124.2025.2486304","DOIUrl":"10.1080/17474124.2025.2486304","url":null,"abstract":"Introduction: A subset of gastrointestinal stromal tumors (GISTs) lacks the common mutations in KIT/PDGFRa genes. This is a rare and heterogeneous group of challenging GISTs due to their diversity and absence of sensitivity to the tyrosine kinase inhibitor (TKI) imatinib.Areas covered: In this manscript, we review the pathogenesis, natural history, diagnostic features and management of KIT/PDGFRa wild-type (WT) GISTs, including SDH-deficient GISTs, GISTs with mutations in the RAS/RAF pathway, and quadruple WT GISTs which lack mutations in either KIT/PDGFRa and SDH genes or components of the RAS/RAF pathway, and syndromic GISTs as well as GISTs with rare KIT/PDGFRa mutations.Expert opinion: Patients should be managed in reference centers. There has been progress in the understanding of the biology of these GISTs, and promising therapeutic targets have been identified. In SDH-deficient GISTs, the TKI olverembatinib has shown encouraging clinical activity but requires further clinical validation, while the HIF2a inhibitor bezultifan and temozolomide alone or in combination with the death receptor agonist 5 are under clinical investigation. Targeting the RAS/RAF pathway in RAS/RAF-mutated GISTs warrants evaluation in clinical trials. Rare molecular alterations in quadruple WT GISTs require investigation for their oncogenic potential. Collaborative research and patient advocacy is critical for these extremely rare tumors.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-13"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The reliability of freely accessible, baseline, general-purpose large language model generated patient information for frequently asked questions on liver disease: a preliminary cross-sectional study.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-02-27 DOI: 10.1080/17474124.2025.2471874

Madunil A Niriella, Pathum Premaratna, Mananjala Senanayake, Senerath Kodisinghe, Uditha Dassanayake, Anuradha Dassanayake, Dileepa S Ediriweera, H Janaka de Silva

{"title":"The reliability of freely accessible, baseline, general-purpose large language model generated patient information for frequently asked questions on liver disease: a preliminary cross-sectional study.","authors":"Madunil A Niriella, Pathum Premaratna, Mananjala Senanayake, Senerath Kodisinghe, Uditha Dassanayake, Anuradha Dassanayake, Dileepa S Ediriweera, H Janaka de Silva","doi":"10.1080/17474124.2025.2471874","DOIUrl":"10.1080/17474124.2025.2471874","url":null,"abstract":"Background: We assessed the use of large language models (LLMs) like ChatGPT-3.5 and Gemini against human experts as sources of patient information.Research design and methods: We compared the accuracy, completeness and quality of freely accessible, baseline, general-purpose LLM-generated responses to 20 frequently asked questions (FAQs) on liver disease, with those from two gastroenterologists, using the Kruskal-Wallis test. Three independent gastroenterologists blindly rated each response.Results: The expert and AI-generated responses displayed high mean scores across all domains, with no statistical difference between the groups for accuracy [H(2) = 0.421, p = 0.811], completeness [H(2) = 3.146, p = 0.207], or quality [H(2) = 3.350, p = 0.187]. We found no statistical difference between rank totals in accuracy [H(2) = 5.559, p = 0.062], completeness [H(2) = 0.104, p = 0.949], or quality [H(2) = 0.420, p = 0.810] between the three raters (R1, R2, R3).Conclusion: Our findings outline the potential of freely accessible, baseline, general-purpose LLMs in providing reliable answers to FAQs on liver disease.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"437-442"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What can real-world data teach us about treating patients with unresectable hepatocellular carcinoma?

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-03-10 DOI: 10.1080/17474124.2025.2476541

A Dalbeni, F Cattazzo, L A Natola, M Zoncapè, D Faccincani, B Stefanini, F Ravaioli, R Villani, A Auriemma, D Sacerdoti

{"title":"What can real-world data teach us about treating patients with unresectable hepatocellular carcinoma?","authors":"A Dalbeni, F Cattazzo, L A Natola, M Zoncapè, D Faccincani, B Stefanini, F Ravaioli, R Villani, A Auriemma, D Sacerdoti","doi":"10.1080/17474124.2025.2476541","DOIUrl":"10.1080/17474124.2025.2476541","url":null,"abstract":"Introduction: Hepatocellular carcinoma (HCC) remains a major global health concern, as it is the most common primary liver cancer and the fourth leading cause of cancer-related mortality.Areas covered: Immune checkpoint inhibitors (ICIs) have significantly shifted the treatment paradigm, offering promising survival outcomes. However, the controlled conditions of randomized clinical trials (RCTs) often fail to reflect real-world complexities, emphasizing the necessity for strong real-world evidence (RWE). RWE, in most cases derived from observational studies, provides critical insights into the effectiveness, safety, and tolerability of systemic therapies across diverse populations and settings. The authors searched MEDLINE, Ovid Embase, and Scopus for full-text published articles in any language from the inception to 30 June 2024.This review evaluates RWE on systemic therapies for advanced HCC, including tyrosine kinase inhibitors (TKIs) like sorafenib and lenvatinib, ICIs such as nivolumab and pembrolizumab, and combination therapies like atezolizumab/bevacizumab and durvalumab/tremelimumab.Expert opinion: Studies reveal discrepancies in treatment efficacy and adverse event profiles between RCTs and routine clinical practice, underscoring the need for individualized treatment strategies. RWE highlights the influence of liver disease etiology, liver function, and tumor burden on treatment outcomes, guiding therapy selection.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"389-398"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transition of care in pediatric hereditary polyposis: the why, how and to whom.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 DOI: 10.1080/17474124.2025.2486299

Thomas M Attard, Ajay Bansal, Caitlin E Lawson, Nicole Stoecklein, Michele H Maddux

{"title":"Transition of care in pediatric hereditary polyposis: the why, how and to whom.","authors":"Thomas M Attard, Ajay Bansal, Caitlin E Lawson, Nicole Stoecklein, Michele H Maddux","doi":"10.1080/17474124.2025.2486299","DOIUrl":"10.1080/17474124.2025.2486299","url":null,"abstract":"Introduction: Transition of care (TOC) is a process that must be planned and executed in a coordinated manner factoring patient, family, disease, and healthcare system. Among youth with gastrointestinal hereditary polyposis syndromes (HPS), poorly planned TOC can have devastating consequences from poor engagement in necessary medical care. This results in increased risk of cancer and related mortality. This review aims to emphasize unique aspects of HPS relevant to TOC, related barriers/challenges, and outline current best practice recommendations.Areas covered: A review was undertaken of transition-focused practice guidelines among youth with chronic conditions, as well as literature from major pediatric gastroenterology societies on the ideal approach for managing polyposis syndromes. Literature from PubMed and Medline, including conference abstracts and proceedings, was reviewed and in the absence of empirically supported evidence, recommendations reflect the opinion of the author experts involved in the care of adolescents and young adults (AYA) with HPS.Expert opinion: Effective TOC requires a structured, patient-centered, individualized process that includes early engagement, incremental education, and multidisciplinary collaboration. Given the unique aspects of HPS, including complex psychosocial and medical needs, there is urgent need for research toward evidence-based strategies enhancing continuity, and mitigating socio-cultural and financial barriers to care.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-9"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Misinterpretation and misapplication of biomarkers in inflammatory bowel disease: how do we avoid this?

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-03-25 DOI: 10.1080/17474124.2025.2482980

Robert B Varley, James C Lee

{"title":"Misinterpretation and misapplication of biomarkers in inflammatory bowel disease: how do we avoid this?","authors":"Robert B Varley, James C Lee","doi":"10.1080/17474124.2025.2482980","DOIUrl":"10.1080/17474124.2025.2482980","url":null,"abstract":"Introduction: The management of inflammatory bowel disease (IBD) has evolved substantially over the past decade, with the emergence of new advanced therapies presenting unprecedented challenges in clinical decision-making. While these therapies provide patients with more opportunities to get better, biomarkers to guide their use remain elusive.Areas covered: This article highlights the challenges associated with biomarker discovery, interpretation, and application in IBD - based on literature review, first-hand experience of biomarker discovery, and personal opinion. We highlight problems including the misinterpretation of predictive capabilities, lack of independent validation, and reverse causation in retrospective studies, and explain why associations with clinical parameters or seropositivity to microbial antigens often fail to meet the rigorous performance metrics required for clinical utility. The relative need for different biomarkers is also discussed - particularly in light of recent evidence from the PROFILE trial, which emphasizes the considerably greater risk posed by uncontrolled disease than by the potential side-effects of medications.Expert opinion: Despite multiple challenges, the potential of biomarkers for precision medicine in IBD remains promising, particularly in combination with other clinical and biochemical parameters. Further research into combinatorial biomarker approaches is needed, but must be combined with learning how to communicate results that are inherently uncertain.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"359-363"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combining therapeutic agents to target the immune systems of hepatitis B patients: what do we need to consider?

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-03-09 DOI: 10.1080/17474124.2025.2477256

Shang-Chin Huang, Jia-Horng Kao

{"title":"Combining therapeutic agents to target the immune systems of hepatitis B patients: what do we need to consider?","authors":"Shang-Chin Huang, Jia-Horng Kao","doi":"10.1080/17474124.2025.2477256","DOIUrl":"10.1080/17474124.2025.2477256","url":null,"abstract":"Introduction: Chronic hepatitis B (CHB) remains a major global health challenge, with functional cure achieved in only a small subset of patients. Current oral antiviral agents effectively suppress viral replication but fail to eliminate the hepatitis B virus (HBV). Recent advances in immunomodulatory therapies offer new hope for improving functional cure rates.Areas covered: This special report discusses the latest therapeutic strategies targeting immune responses in CHB. We list the mechanisms of immune evasion in HBV infection and highlight emerging immunomodulatory agents. Key findings from recent clinical trials and critical considerations are summarized to provide an overview of ongoing efforts and future direction to achieve functional cure.Expert opinion: While combination therapies hold promise, their real-world feasibility depends on patient selection, combination regimens, costs, and global accessibility. A successful HBV cure strategy must integrate scientific innovation with public health policies to ensure equitable access to effective treatments. Future research should identify key immune mechanisms, optimize combination regimens, and improve global treatment infrastructure.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"371-375"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Noninvasive identification of metabolic dysfunction-associated steatohepatitis (INFORM MASH): a retrospective cohort and disease modeling study.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-04-01 Epub Date: 2025-03-21 DOI: 10.1080/17474124.2025.2477249

G Craig Wood, Anthony Hoovler, Rakesh Luthra, Christopher D Still, Hamzah Shariff, Matthew Still, Jonathan Hayes, Peter Benotti, Chioma Uzoigwe

{"title":"Noninvasive identification of metabolic dysfunction-associated steatohepatitis (INFORM MASH): a retrospective cohort and disease modeling study.","authors":"G Craig Wood, Anthony Hoovler, Rakesh Luthra, Christopher D Still, Hamzah Shariff, Matthew Still, Jonathan Hayes, Peter Benotti, Chioma Uzoigwe","doi":"10.1080/17474124.2025.2477249","DOIUrl":"10.1080/17474124.2025.2477249","url":null,"abstract":"Background: Using common clinical parameters, we aimed to noninvasively identify and predict metabolic dysfunction-associated steatohepatitis (MASH)/MASH with clinically significant fibrosis.Research design and methods: Patients aged ≥18 with electronic health record (EHR) documented liver function tests and liver biopsies between 2016 and 2021 were retrospectively identified from the Geisinger Health System Research Liver Registry. MASH cases were confirmed using the nonalcoholic fatty liver disease (NAFLD) activity score. Training and validation datasets were used to create an algorithm/predictive model assessing EHR-derived predictors of MASH/MASH with clinically significant fibrosis (fibrosis stage F2-F4). Predictive accuracy was evaluated using the area under the curve.Results: The analysis included 2698 patients. We created a composite likelihood score using variables significant for MASH and/or MASH with clinically significant fibrosis: liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST]), prior year AST, metabolic disease, pulse (heart rate), and body mass index. The score had higher sensitivity and specificity for predicting MASH than Fibrosis-4 (FIB-4) Index, AST to platelet ratio index (APRI), and NAFLD fibrosis score (NFS); sensitivity and specificity were comparable to FIB-4 and APRI for predicting MASH with clinically significant fibrosis but superior to NFS.Conclusion: The composite likelihood score could potentially be a tool for early MASH screening.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"427-435"},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0