Screening for Nonalcoholic Fatty Liver Disease in Persons with Type 2 Diabetes in the United States Is Cost-effective: A Comprehensive Cost-Utility Analysis
Open accessAbstract
The US Preventative Services Task Force has no guidelines on the screening for nonalcoholic fatty liver disease (NAFLD), and the American Association for the Study of Liver Diseases (AASLD) guidance does not recommend population screening for NAFLD.1 A reference cited by this guidance concluded that screening is not cost-effective2; however, new data have emerged since then. We hypothesize that screening for NAFLD in patients with type 2 diabetes (T2D), starting with ultrasound (US) and alanine aminotransferase or aspartate aminotransferase and followed by noninvasive testing for fibrosis to detect those most likely to have fibrosis stage ≥F2, is more cost-effective than not screening this population.
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The Liver Forum is an all-stakeholders working group seeking to improve diagnostics in MASH.
“Working cooperatively with these consortia has been the Liver Forum, an all-stakeholders working group seeking to improve diagnostics in MASH (310).”
From Found in translation—Fibrosis in metabolic dysfunction–associated steatohepatitis (MASH) (2023) · cites this paper as [310]
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Association of histologic disease activity with progression of nonalcoholic fatty liver disease
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Corey, K. E., Klebanoff, M. J., Tramontano, A. C., Chung, R. T., & Hur, C. (2016) · Digestive Diseases and Sciences · doi:10.1007/s10620-016-4044-2 · Cited by 84 · see citing works
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Rinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S., Barb, D., Kleiner, D. E., & Loomba, R. (2023) · Hepatology · doi:10.1097/hep.0000000000000323 · Cited by 2,667 · see citing works
Self-citationTacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
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Self-citationKanwal, F., Shubrook, J. H., Adams, L. A., Pfotenhauer, K., Wai-Sun Wong, V., Wright, E., Abdelmalek, M. F., Harrison, S. A., Loomba, R., Mantzoros, C. S., et al. (2021) · Gastroenterology · doi:10.1053/j.gastro.2021.07.049 · Cited by 618 · see citing works
Long, M. T., Noureddin, M., & Lim, J. K. (2022) · Gastroenterology · doi:10.1053/j.gastro.2022.06.023 · Cited by 299 · see citing works
Self-citationFound in translation—Fibrosis in metabolic dysfunction–associated steatohepatitis (MASH)
Wang, S., & Friedman, S. L. (2023) · Science Translational Medicine · doi:10.1126/scitranslmed.adi0759 · Cited by 158 · see citing works
Glucagon-like Peptide-1 Receptor Agonist Use in Patients With Liver Cirrhosis and Type 2 Diabetes
Yen, F.-S., Hou, M.-C., Cheng-Chung Wei, J., Shih, Y.-H., Hsu, C. Y., Hsu, C.-C., & Hwu, C.-M. (2024) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2023.06.004 · Cited by 73 · see citing works
Implementation of a liver health check in people with type 2 diabetes
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Authors, & Collaborators: (2022) · Zeitschrift für Gastroenterologie · doi:10.1055/a-1880-2388 · Cited by 30 · see citing works
Patient-centered care: Key elements applicable to chronic liver disease
Verma, M., Brahmania, M., Fortune, B. E., Asrani, S. K., Fuchs, M., & Volk, M. L. (2023) · Hepatology · doi:10.1002/hep.32618 · Cited by 24 · see citing works
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- Authors
- Noureddin, M., Jones, C., Alkhouri, N., Gomez, E. V., Dieterich, D. T., Rinella, M. E., Therapondos, G., Girgrah, N., Mantry, P. S., Sussman, N. L., Figueroa Diaz, V., & Fuchs, M.
- Affiliations
- Cedars-Sinai Medical Center (US)
- The University of Texas at San Antonio Health Science Center (US)
- Icahn School of Medicine at Mount Sinai (US)
- Northwestern University (US)
- Corresponding author
- Noureddin, Mazen
- ORCID
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 159
- Issue
- 5
- Pages
- 1985-1987.e4
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W3047297860
- Cited by
- 140
- References
- 4
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 17 · 2023: 23 · 2022: 30 · 2021: 26 · 2020: 5
- FWCI
- 15.10
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-05-01)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Gastroenterology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- non-alcoholic fatty liver disease, type 2 diabetes, screening, cost-effectiveness, cost-utility analysis, liver ultrasound, alanine aminotransferase, aspartate aminotransferase, liver fibrosis, USPSTF recommendations, AASLD guidelines
- MeSH terms
- Healthy Lifestyle, Diagnostic Screening Programs, Cost-Benefit Analysis, Diabetes Mellitus, Type 2, Humans, Liver Cirrhosis, Markov Chains, Predictive Value of Tests, Quality of Life, Risk Factors, United States, Reproducibility of Results, Treatment Outcome, Health Care Costs, Models, Economic, Quality-Adjusted Life Years, Risk Reduction Behavior, Non-alcoholic Fatty Liver Disease
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