Survey of physicians’ knowledge about pediatric nonalcoholic fatty liver disease in China
Xiang Yang Gao , Yi Fan Yang , Li Li , Yun Fei Xing , You Xin Wang , Xue Ying Li , Shu Han Yang , Ming Yue Wang , Jian Gao Fan , Hui Wang
Journal of Digestive Diseases ›› 2024, Vol. 25 ›› Issue (6) : 380 -393.
Survey of physicians’ knowledge about pediatric nonalcoholic fatty liver disease in China
Objectives: To evaluate physicians’ awareness and knowledge towards pediatric nonalcoholic fatty liver disease (NAFLD) and their attitude toward change in nomenclature from NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) in China.
Methods: The questionnaire survey contained five parts (characteristics of the participants, epidemiology, diagnosis, management of NAFLD, and attitudes toward the nomenclature of MAFLD/MASLD). The participants included 53 hepatologists, 88 gastroenterologists (GEs), 74 endocrinologists (ENDOs), 61 primary care physicians (PCPs), and 157 pediatricians across 31 municipalities, provinces and autonomous regions of China’s mainland.
Results: Hepatologists saw the largest number of pediatric NAFLD patients annually (median 9 [range 1–20]), with the lowest number by PCPs (even notwithstanding one patient annually). The primary sources of pediatric NAFLD knowledge were acquired via guidelines. Hepatologists had the highest total knowledge score among all five types of physicians. Approximately one-third of nonspecialists (ENDOs and PCPs) considered liver biopsy necessary for pediatric NAFLD patients, and this percentage increased to half in specialists (hepatologists and GEs). For nonspecialists, the major barriers to the management of pediatric NAFLD were poor patient adherence to lifestyle modifications and lacking confidence in managing NAFLD. Above 90% physicians agreed to change the nomenclature NAFLD to MAFLD; however, they were not sure whether it could reduce the economic burden.
Conclusions: Despite the epidemic of pediatric NAFLD in China, a significant knowledge gap remains in the identification, diagnosis, and treatment of pediatric NAFLD, particularly among frontline workers such as pediatricians and PCPs. More education programs should be carried out in the future.
awareness / disease management / knowledge / non-alcoholic fatty liver disease / pediatrics
2024 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.
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