Alcoholic Liver Disease

Dasarathy, Srinivasan; McCullough, Arthur J.

doi:10.1002/9781119950509.ch26

Cited by 3 publications

(2 citation statements)

References 445 publications

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“…depression, anxiety) conditions. 2–5 Interventions designed to reduce excessive alcohol consumption, delivered face-to-face by trained healthcare professionals, are available in many countries. 6–8 However, rising demand and pressures on national health budgets mean these services are limited and not meeting needs.…”

Section: Introductionmentioning

confidence: 99%

Engagement features judged by excessive drinkers as most important to include in smartphone applications for alcohol reduction: A mixed-methods study

et al. 2018

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Objective Engagement with smartphone applications (apps) for alcohol reduction is necessary for their effectiveness. This study explored (1) the features that are ranked as most important for engagement by excessive drinkers and (2) why particular features are judged to be more important for engagement than others. Methods Two studies were conducted in parallel. The first was a focus group study with adult excessive drinkers, interested in reducing alcohol consumption using an app ( n groups = 3). Participants individually ranked their top 10 features from a pre-specified list and subsequently discussed their rankings. The second was an online study with a new sample ( n = 132). Rankings were analysed using the intraclass correlation coefficient (ICC) to assess the level of agreement between raters for each study. Qualitative data were analysed using inductive thematic analysis. Results There was low agreement between participants in their rankings, both in the focus groups (ICC = 0.15, 95% confidence interval (CI) = 0.03–0.38) and the online sample (ICC = 0.11, 95% CI = 0.06–0.23). ‘Personalisation’, ‘control features’ and ‘interactive features’ were most highly ranked in the focus groups. These were expected to elicit a sense of benefit and usefulness, adaptability, provide motivational support or spark users’ interest. Results from the online study partly corroborated these findings. Conclusion There was little agreement between participants, but on average, the features judged to be most important for inclusion in smartphone apps for alcohol reduction were personalisation, interactive features and control features. Tailoring on users’ underlying psychological needs may promote engagement with alcohol reduction apps.

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Section: Introductionmentioning

confidence: 99%

Engagement features judged by excessive drinkers as most important to include in smartphone applications for alcohol reduction: A mixed-methods study

et al. 2018

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“…Hypoalbuminemia occurs due to the decreased hepatic synthetic function as well as coexisting protein-energy malnutrition. The level of hyperbilirubinemia and abnormal PT reflects the severity of AH and is of prognostic value [11,12,13]. Available scoring systems for assessing the severity and prognosis of AH are Modified MDF based on PT and serum bilirubin concentration; GAHS that uses variables including age, blood urea, peripheral blood leukocyte count, serum bilirubin, and PT; the MELD score using bilirubin, creatinine, and INR levels; the Lille model which combines six variables (age, renal insufficiency, albumin, PT, bilirubin, and evolution of bilirubin on day 7).…”

Section: Discussionmentioning

confidence: 99%

Performance of a calculator for diagnosing the cause of liver damage

et al. 2019

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Introduction/Objective Making a calculator that would recognize patterns of abnormal liver function tests and link them to the most probable etiology could help clinicians in their initial orientation towards a definitive diagnosis in patients with liver damage. The aim of our study was to design, construct, and validate a calculator that based on a pattern of abnormalities in liver function tests of a patient with liver damage would propose the most probable etiology. Methods Patterns of abnormal liver function tests for certain etiology of liver damage were extracted from distributions of actual values taken from reports in medical literature about patients whose etiology of liver damage was proven by reliable diagnostic tests. After setting up the calculator with the patterns extracted, its diagnostic value was checked under real-life conditions, on a sample of patients with liver damage whose etiology was established by the gold standard of diagnostics (biopsy or else). The calculator validation study was carried out at the Military Medical Academy in Belgrade during a two-year period (2015)(2016). Results For all tested diagnoses, the calculator demonstrated a highly significant difference between the area under the receiver-operator curves' values and the value of 0.5 (p < 0.001), and high level of sensitivity (more than 90%, except for the model for chronic hepatitis) as well as relatively high specificity (more than 75%) were noted, indicating good ability of the calculator to detect etiology of liver damage. Conclusion New calculators showed satisfactory sensitivity and specificity for revealing major liver damage etiologies.

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Cost-Effectiveness Analysis of Deep Brain Stimulation for the Treatment of Alcohol Use Disorder and Alcoholic Liver Disease

Abiola,

Lehmann,

Moussawi

et al. 2024

Preprint

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BackgroundAlcohol use disorder (AUD) is a major public health concern and cause of mortality and morbidity. Alcohol-associated liver disease (ALD) is a debilitating complication of AUD, mitigated by abstinence from alcohol use. Deep brain stimulation (DBS) is emerging as a potential treatment for AUD. However, its cost-effectiveness compared to the standard medical treatment is unclear.ObjectiveTo estimate the cost-effectiveness of DBS compared to medical management for patients with AUD and ALD.MethodsWe utilized a decision analytic model based on published literature to conduct a cost-effectiveness analysis of costs and health outcomes for DBS and medical management in patients with AUD and ALD. We also carried out a threshold analysis to determine the probability of success necessary for DBS to be cost-effective. Costs were measured in 2024 US dollars and effectiveness in quality-adjusted life years (QALYs). We used a time horizon of 1-2 years and adopted a societal perspective.ResultsOur results show that for AUD patients in general, DBS is not cost-effective at any DBS success rate. However, for advanced ALD patients, defined as fibrosis stage 3 or beyond DBS becomes cost-effective. For these patients, DBS is cost-effective over a two-year period at a $100,000 willingness-to-pay threshold at DBS success rates greater than 53%. For advanced decompensated ALD patients, DBS is cost-effective over a one-year period at DBS success rate greater than 35%.ConclusionShould it prove efficacious, DBS may be cost-effective for patients with AUD and ALD. Thus, future randomized controlled trials to evaluate its efficacy are warranted.

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Alcoholic Liver Disease

Cited by 3 publications

References 445 publications

Engagement features judged by excessive drinkers as most important to include in smartphone applications for alcohol reduction: A mixed-methods study

Engagement features judged by excessive drinkers as most important to include in smartphone applications for alcohol reduction: A mixed-methods study

Performance of a calculator for diagnosing the cause of liver damage

Cost-Effectiveness Analysis of Deep Brain Stimulation for the Treatment of Alcohol Use Disorder and Alcoholic Liver Disease

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