Liver Diseases NAFLD and NASH: An Overview and a Real-World Evidence-Based Study by Veradigm®

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Thought Leadership  |  14 July 2020  |  By John M. Farah, PhD

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Nonalcoholic fatty liver disease (NAFLD) is fast becoming a personal and public health concern worldwide. NAFLD describes a spectrum of increasingly serious hepatic (i.e., related to the liver) diseases, from nonalcoholic fatty liver (NAFL), also called simple fatty liver, to nonalcoholic steatohepatitis (NASH), a more aggressive form of the disease. Over the last decade, the prevalence of NAFLD has increased steadily, alongside rising rates of obesity and type 2 diabetes.

Real-world evidence studies have provided insights into the challenges associated with NAFLD. Studies that have explored diagnostic gaps, risk factors and clinical predictors, and long-term outcomes suggest there is an ongoing need for screening, risk stratification, and referrals to specialists in order to improve care for these conditions.

Veradigm has recently written two new papers on this topic:

The first paper, Real-World Complexity of NAFLD and NASH: Identifying and Addressing Gaps in Diagnosis and Disease Management, provides a brief overview of NAFLD that touches on cardiometabolic risk, screening, diagnosis, management, and potential therapeutic candidates for those who may not be familiar with these conditions.

The second paper, Prevalence and Characteristics of NAFLD/NASH Patients in US Real-World Clinical Practice, presents the findings from a real-world study conducted by Veradigm leveraging de-identified patient data sourced from one of Veradigm’s large, cloud-based US electronic health record (EHR) platforms available through the Health Insights clinical database.

This retrospective cohort analysis revealed a lower than expected five-year prevalence of NAFLD and NASH that appears to reflect an underreporting of NAFLD-related diagnoses in the primary care setting. The analysis also showed that a substantial proportion of patients were not being treated for cardiometabolic comorbidities and that some patients who were at high risk of fibrosis had no recorded diagnosis codes for more severe disease. The paper discusses clinical implications and potential solutions, including AI-based approaches to screening, use of risk predictive calculators, and dissemination of educational materials from within EHRs that may help to address current gaps in diagnosis and disease management of NAFLD.

The Health Insights database and other clinical data sources (the PINNACLE Registry® and the Diabetes Collaborative Registry®) are available from Veradigm to support the research needs of biopharma, clinical research organizations (CROs), payers, and other healthcare industry stakeholders. Veradigm Health Insights and the registries, combined with artificial intelligence (AI) and data enrichment analytic tools can enable the extraction of meaningful real-world data on a wide range of conditions. For more information on the unique datasets and analytic services offered by Veradigm, contact us.

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