Browsing by Author "Yu, Ming-Lung"

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    A Global Survey of Physicians Knowledge About Nonalcoholic Fatty Liver Disease
    (2022) Younossi, Zobair M.; Ong, Janus P.; Takahashi, Hirokazu; Yilmaz, Yusuf; Hi, Yuichiro Eguc; El Kassas, Mohamed; Buti, Maria; Diago, Moises; Zheng, Ming-Hua; Fan, Jian-Gao; Yu, Ming-Lung; Wong, Vincent Wai-Sun; Alswat, Khalid; Chan, Wah-Kheong; Mendez-Sanchez, Nahum; Burra, Patrizia; Bugianesi, Elisabetta; Duseja, Ajay K.; George, Jacob; Papatheodoridis, George, V; Saeed, Hamid; Castera, Laurent; Arrese, Marco; Kugelmas, Marcelo; Romero-Gomez, Manuel; Alqahtani, Saleh; Ziayee, Mariam; Lam, Brian; Younossi, Issah; Racila, Andrei; Henry, Linda; Stepanova, Maria
    BACKGROUND & AIMS: Despite rapidly increasing nonalcoholic fatty liver disease (NAFLD) prevalence, providers' knowledge may be limited. We assessed NAFLD knowledge and associated factors among physicians of different specialties globally.
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    Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease
    (2024) Younossi, Zobair M.; Alqahtani, Saleh A.; Alswat, Khalid; Yilmaz, Yusuf; Keklikkiran, Caglayan; Funuyet-Salas, Jesus; Romero-Gomez, Manuel; Fan, Jian-Gao; Zheng, Ming-Hua; El-Kassas, Mohamed; Castera, Laurent; Liu, Chun-Jen; Wong, Vincent Wai-Sun; Zelber-Sagi, Shira; Allen, Alina M.; Lam, Brian; Treeprasertsuk, Sombat; Hameed, Saeed; Takahashi, Hirokazu; Kawaguchi, Takumi; Schattenberg, Joern M.; Duseja, Ajay; Newsome, Phil N.; Francque, Sven; Spearman, C. Wendy; Fernandez, Marlen I. Castellanos; Burra, Patrizia; Roberts, Stuart K.; Chan, Wah-Kheong; Arrese, Marco; Silva, Marcelo; Rinella, Mary; Singal, Ashwani K.; Gordon, Stuart; Fuchs, Michael; Alkhouri, Naim; Cusi, Kenneth; Loomba, Rohit; Ranagan, Jane; Eskridge, Wayne; Kautz, Achim; Ong, Janus P.; Kugelmas, Marcelo; Eguchi, Yuichiro; Diago, Moises; Yu, Ming-Lung; Gerber, Lynn; Fornaresio, Lisa; Nader, Fatema; Henry, Linda; Racila, Andrei; Golabi, Pegah; Stepanova, Maria; Carrieri, Patrizia; Lazarus, Jeffrey, V
    Background & Aims: Patients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers. Methods: Members of the Global NASH Council created two surveys about experiences/attitudes toward NAFLD and related diagnostic terms: a 68-item patient and a 41-item provider survey. Results: Surveys were completed by 1,976 patients with NAFLD across 23 countries (51% Middle East/North Africa [MENA], 19% Europe, 17% USA, 8% Southeast Asia, 5% South Asia) and 825 healthcare providers (67% gastroenterologists/hepatologists) across 25 countries (39% MENA, 28% Southeast Asia, 22% USA, 6% South Asia, 3% Europe). Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was "fatty liver" (88% at least sometimes); "metabolic disease" or "MAFLD" were rarely used (never by >84%). Regarding various perceptions of diagnostic terms by patients, there were no substantial differences between "NAFLD", "fatty liver disease (FLD)", "NASH", or "MAFLD". The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with "FLD" among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD. Among providers, 38% believed that the term "fatty" was stigmatizing, while 34% believed that "nonalcoholic" was stigmatizing, more commonly in MENA (43%); 42% providers (gastroenterologists/hepatologists 45% vs. 37% other specialties, p = 0.03) believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting "steatotic liver disease" as stigmatizing was low (14%). Conclusions: The perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties. (c) 2023 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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    The case for simplifying and using absolute targets for viral hepatitis elimination goals
    (2021) Razavi, Homie; Blach, Sarah; Razavi-Shearers, Devin; Abaalkhail, Faisal; Abbas, Zaigham; Abdallah, Ayat; Ferreira, Paulo Abrao; Abu Raddad, Laith Jamal; Adda, Danjuma; Agarwal, Kosh; Aghemo, Alessio; Ahmed, Aijaz; Al-Busafi, Said A.; Al-hamoudi, Waleed; Al-Kaabi, Saad; Al-Romaihi, Hamad; Aljarallah, Badr; AlNaamani, Khalid; Alqahtani, Saleh; Alswat, Khalid; Altraif, Ibrahim; Asselah, Tarik; Bacon, Bruce; Bessone, Fernando; Bizri, Abdul Rahman; Block, Tim; Bonino, Ferruccio; BranclaoMello, Carlos Eduardo; Browny, Kimberly; Bruggmann, Philip; Brunetto, Maurizia Rossana; Buti, Maria; Cabezas, Joaquin; Calleja, Jose Luis; Batanjer, Erika Castro; Chan, Henry Lik-Yuen; Chang, Henry; Chen, Chien-Jen; Christensen, Peer Brehm; Chuang, Wan-Long; Cisneros, Laura; Cohen, Chari; Colombo, Massimo; Conway, Brian; Cooper, Curtis; Craxi, Antonio; Crespo, Javier; Croes, Esther; Cryer, Donna; de Barros, Fernando Passos Cupertino; Derbala, Moutaz; Dillon, John; Doss, Wahid; Dou, Xiaoguang; Doyle, Joseph; Duberg, Ann-Sofi; Dugan, Ellen; Dunn, Rick; Dusheiko, Geoffrey; El Khayat, Hisham; EI-Sayed, Manal H.; Eshraghian, Ahad; Esmat, Gamal; Mur, Rafael Esteban; Ezzat, Sameera; Falconer, Karolin; Fassio, Eduardo; Ferrinho, Paulo; Flamm, Steven; Flisiak, Robert; Foster, Graham; Fung, James; Garcia-Samaniego, Javier; Gish, Robert G.; Goncales, Fernando; Halota, Waldemar; Hamoudi, Waseem; Hassany, Mohamed; Hatzakis, Angelos; Hay, Susan; Himatt, Sayed; Hoepelman, I. M.; Hsu, Yao-Chun; Hui, Yee Tak; Hunyady, Bela; Jacobson, Ira; Janjua, Naveed; Janssen, Harry; Jarcuska, Peter; Kabagambe, Kenneth; Kanto, Tatsuya; Kao, Jia-Horng; Kaymakoglu, Sabahattin; Kershenobich, David; Khamis, Faryal; Kim, Dong Joon; Kim, Young; Kondili, Loreta A.; KottiliI, Shyamasundaran; Kramvis, Anna; Kugelmas, Marcelo; Kurosaki, Masayuki; Lacombe, Karine; Lagging, Martin; Lao, WaiCheung; Lavanchy, Daniel; Lazarus, Jeffrey, V; Lee, Alice; Lee, Samual S.; Levyl, Miriam; Liakina, Valentina; Lim, YoungSuk; Liu, Shuang; Maddrey, Willis; Malekzade, Reza; Marinho, Rui Tato; Mathur, Poonam; Maticic, Mojca; Mendes Correa, Maria Cassia; Mera, Jorge; Merat, Shahin; Mogawer, Sherif; Mohamed, Rosmawati; Muellhaupti, Beat; Muljono, David; Mostafa, Ibrahim; Nahum, Mendez Sanchez; Nawaz, Arif; Negro, Francesco; Ninburg, Michael; Ning, Qing; Ntiri-Reid, Boatemaa; Nymadawa, Pagbajabyn; Oevrehus, Anne; Ormeci, Necati; Orrego, Mauricio; Osman, Alaa; Oyunsuren, Tsendsuren; Pant, Calvin; Papaevangelou, Vassiliki; Papatheodoridis, George; Popping, Stephanie; Prasad, Papu; Prithiviputh, Rittoo; Qureshi, Huma; Ramji, Alnoor; Razavi-Shearer, Kathryn; Reddy, Rajender; Remak, William; Richter, Clemens; Ridruejo, Ezequiel; Robaeys, Geert; Robert, Stuart; Roberts, Lewis; Roudot-Thoraval, Francoise; Saab, Sammy; Said, Sanaa; Salamat, Amjad; Sanai, Faisal; Sanchez-Avila, Juan Francisco; Schiff, Eugene; Schinazi, Raymond; Sebastiani, Giada; Seguin-Devaux, Carole; Shanmugam, R. P.; Sharara, Ala; Shilton, Sonjelle; Shouval, Daniel; Sievert, William; Simonova, Marieta; Sohrabpour, Amir Ali; Sonderup, Mark; Soza, Alejandro; Spearman, C. Wendy; Steinfurth, Nancy; Sulkowski, Mark; Tan, Soek-Siam; Tanaka, Junko; Tashi, Dhondup; Thein, Hla-Hla; Thompson, Peyton; Tolmane, Ieva; Toy, Mehlika; Valantinas, Jonas; Van de Vijver, David; Velez-Moller, Patricia; Vince, Adriana; Waked, Imam; Wang, Su; Wedemeyer, Heiner; Wong, Vincent; Xie, Qing; Yamada, Seiji; Yang, Hwai-, I; Yesmembetov, Kakharman; Yilmaz, Yusuf; Younossi, Zobair; Yu, Ming-Lung; Yuen, Man-Fung; Yurdaydin, Cihan; Yusuf, Aasim; Zekry, Amany; Zeuzem, Stefan
    The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries' progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to <= 5 per 100 000, reduce HBV prevalence among 1-year-olds to <= 0.1%, reduce HBV and HCV mortality to <= 5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.
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    The impact of stigma on quality of life and liver disease burden among patients with nonalcoholic fatty liver disease
    (2024) Younossi, Zobair M.; AlQahtani, Saleh A.; Funuyet-Salas, Jesus; Romero-Gomez, Manuel; Yilmaz, Yusuf; Keklikkiran, Caglayan; Alswat, Khalid; Yu, Ming-Lung; Liu, Chun-Jen; Fan, Jian-Gao; Zheng, Ming-Hua; Burra, Patrizia; Francque, Sven M.; Castera, Laurent; Schattenberg, Joern M.; Newsome, Philip N.; Allen, Alina M.; El-Kassas, Mohamed; Treeprasertsuk, Sombat; Hameed, Saeed; Wong, Vincent Wai-Sun; Zelber-Sagi, Shira; Takahashi, Hirokazu; Kawaguchi, Takumi; Fernandez, Marlen I. Castellanos; Duseja, Ajay; Arrese, Marco; Rinella, Mary; Singal, Ashwani K.; Gordon, Stuart C.; Fuchs, Michael; Eskridge, Wayne; Alkhouri, Naim; Cusi, Kenneth; Loomba, Rohit; Ranagan, Jane; Kautz, Achim; Ong, Janus P.; Kugelmas, Marcelo; Eguchi, Yuichiro; Diago, Moises; Gerber, Lynn; Lam, Brian; Fornaresio, Lisa; Nader, Fatema; Spearman, C. Wendy; Roberts, Stuart K.; Chan, Wah-Kheong; Silva, Marcelo; Racila, Andrei; Golabi, Pegah; Ananchuensook, Prooksa; Henry, Linda; Stepanova, Maria; Carrieri, Patrizia; Lazarus, Jeffrey, V
    Background & Aims: Patients with nonalcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) face a multifaceted disease burden which includes impaired health-related quality of life (HRQL) and potential stigmatization. We aimed to assess the burden of liver disease in patients with NAFLD and the relationship between experience of stigma and HRQL. Methods: Members of the Global NASH Council created a survey about disease burden in NAFLD. Participants completed a 35-item questionnaire to assess liver disease burden (LDB) (seven domains), the 36-item CLDQ-NASH (six domains) survey to assess HRQL and reported their experience with stigmatization and discrimination. Results: A total of 2,117 patients with NAFLD from 24 countries completed the LDB survey (48% Middle East and North Africa, 18% Europe, 16% USA, 18% Asia) and 778 competed CLDQ-NASH. Of the study group, 9% reported stigma due to NAFLD and 26% due to obesity. Participants who reported stigmatization due to NAFLD had substantially lower CLDQ-NASH scores (all p <0.0001). In multivariate analyses, experience with stigmatization or discrimination due to NAFLD was the strongest independent predictor of lower HRQL scores (beta from -5% to -8% of score range size, p <0.02). Experience with stigmatization due to obesity was associated with lower Activity, Emotional Health, Fatigue, and Worry domain scores, and being uncomfortable with the term "fatty liver disease" with lower Emotional Health scores (all p <0.05). In addition to stigma, the greatest disease burden as assessed by LDB was related to patients' self-blame for their liver disease. Conclusions: Stigmatization of patients with NAFLD, whether it is caused by obesity or NAFLD, is strongly and independently associated with a substantial impairment of their HRQL. Self-blame is an important part of disease burden among patients with NAFLD. Impact and implications: Patients with nonalcoholic fatty liver disease (NAFLD), recently renamed metabolic dysfunction-associated steatotic liver disease (MASLD), may experience impaired health-related quality of life and stigmatization. Using a specifically designed survey, we found that stigmatization of patients with NAFLD, whether it is caused by obesity or the liver disease per se, is strongly and independently associated with a substantial impairment of their quality of life. Physicians treating patients with NAFLD should be aware of the profound implications of stigma, the high prevalence of self-blame in the context of this disease burden, and that providers' perception may not adequately reflect patients' perspective and experience with the disease. (c) 2024 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).