Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis

Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention

“…A study conducted in northeast England found that NAFLD associated HCC accounted for 35% of all HCC cases (41 of 118) in 2010, representing a greater than tenfold increase in 10 years 43 . Finally, results from the UK National Health Service Blood and Transplant Agency show that decompensated NASH cirrhosis accounted for an increased proportion of patients undergoing liver transplantation (12% in 2013 compared with 4% in 1995) 44 .…”

Time to challenge the spurious hierarchy of systematic over narrative reviews?

“…Yet leading medical journals regularly publish clinical topic reviews that may lack a focused research question, methods section or statement on how studies were selected and analysed (see for example7, 8, 9). These narrative reviews typically draw on expert opinion by deliberately recruiting leading names in the field (eg “The aim of this Commission is to provide the strongest evidence base through involvement of experts from a wide cross‐section of disciplines…”—page 1953, emphasis added8).…”

“…These narrative reviews typically draw on expert opinion by deliberately recruiting leading names in the field (eg “The aim of this Commission is to provide the strongest evidence base through involvement of experts from a wide cross‐section of disciplines…”—page 1953, emphasis added8). Reviews crafted through the experience and judgement of experts are often viewed as untrustworthy (“eminence‐based” is a pejorative term).…”

Direct‐acting antiviral drugs and hepatitis C virus: A therapeutic revolution?

“…Although this is particularly true among patients with advanced disease, cost-effectiveness was still observed among patients with low fibrosis stages in genotype 1 hepatitis C virus (HCV). [2][3][4] Although there have been price reductions for these regimens as a result of discounting, our current challenge remains the development of multistakeholder solutions to maximize access to these regimens.…”

“…Last, these new agents should not mask the fact that much wider measures are needed to control the explosion of liver disease in the West and in developing countries. 4 Third, with regard to eradication, the zenith for HCV contamination occurred in the 1980s, with preventative measures (eg, among intravenous drug users). In 3 decades, HCV should almost disappear, with or without the use of DAAs.…”