Author information

¹Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.

²Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

³CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA.

⁴European Association for the Study of the Liver (EASL), Geneva, Switzerland.

⁵Independent consultant, Nottingham, UK.

⁶Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

⁷Department of Medicine, Division of Gastroenterology, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada.

⁸Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada.

⁹Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

¹⁰Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.

¹¹Houston Methodist Hospital, Houston Research Institute, Houston, Texas, USA.

¹²Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK.

¹³Fatty Liver Program, Arizona Liver Health, Phoenix, Arizona, USA.

¹⁴King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.

¹⁵Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.

¹⁶Liver Unit, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

¹⁷Department of Medicine II, Division of Hepatology, Leipzig University Medical Center, Leipzig, Germany.

¹⁸Division of Hepatology, University of Dundee, Dundee, Scotland, UK.

¹⁹Multivisceral Transplant Unit-Gastroenterology, Department of Surgery, Oncology and Gastroenterology at the Padua University Hospital, Padua, Italy.

²⁰Department of Hepatology and Transplant, Hospital Médica Sur, Mexico City, Mexico.

²¹Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

²²Asociación Latinoamericana para el Estudio del Hígado (ALEH), Santiago, Chile.

²³Clinica Universitária de Gastrenterologia, Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.

²⁴Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, University of Florida, Gainesville, Florida, USA.

²⁵Greek Patients Association, Athens, Greece.

²⁶Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

²⁷Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.

²⁸InflaMed Centre of Excellence, Laboratory for Experimental Medicine and Paediatrics, Translational Sciences in Inflammation and Immunology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.

²⁹Institute of Clinical Physiology, National Research Council, Pisa, Italy.

³⁰Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.

³¹CUNY Center for Systems and Community Design and NYU-CUNY Prevention Research Center, New York, New York, USA.

³²Kautz 5 gUG, Köln, Germany.

³³Independent researcher, Ponte de Lima, Portugal.

³⁴Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.

³⁵National Institute for Health Research Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.

³⁶Department of Medicine, University of Chicago, Chicago, Illinois, USA.

³⁷Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA.

³⁸Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

³⁹Hepatology and Clinical Research Units, Hospital Universitario Austral, Buenos Aires, Argentina.

⁴⁰Department of Medicine, Division of Hepatology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

⁴¹Gastrointestinal and Liver Disease Division, University of Southern California, Los Angeles, California, USA.

⁴²UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.

⁴³Precision Medicine, Biological Resource Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

⁴⁴Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

⁴⁵School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.

⁴⁶Department of Gastroenterology, Tel Aviv Medical Centre, Tel Aviv, Israel.

⁴⁷Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany.

⁴⁸The Chinese University of Hong Kong, Hong Kong, China.

⁴⁹Center for Liver Disease, Inova, Falls Church, Virginia, USA.

Abstract

Background and aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care.

Approach and results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of "agree" responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% "agree"). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance.

Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce the prevalence of fatty liver disease and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.